The Complications of Trauma and Their Associated Costs in a Level I Trauma Center
- 1 August 1997
- journal article
- research article
- Published by American Medical Association (AMA) in Archives of Surgery
- Vol. 132 (8), 920-924
- https://doi.org/10.1001/archsurg.1997.01430320122021
Abstract
Objectives:To estimate the expected costs for acute trauma care, to quantify the costs associated with the development of complications in injury victims, and to determine the deficit incurred by patients in whom complications develop.Design:A retrospective, cohort design.Setting:A referral trauma center.Patients:A total of 12 088 patients admitted to a single regional trauma center during a period of 5 years.Interventions:This is an observational study, and no interventions specific to this study are included in the design.Main Outcome Measures:(1) The expected costs for injury victims based on readily available clinical data. (2) The costs associated with the most important complications of trauma. (3) The effect of complications on inadequate reimbursement for trauma care.Results:The expected costs were estimated using a linear model incorporating demographic variables and measures of injury severity. The expected costs averaged $14 567, and the observed costs averaged $15 032. Six complications were important predictors of cost. These included adult respiratory distress syndrome, acute kidney failure, sepsis, pneumonia, decubitus ulceration, and wound infections. For 1201 individuals with these complications, the predicted costs averaged $23 266 and the observed costs averaged $47 457. The mean excess costs for a single complication ranged from $6669 to $18 052. Multiple complications led to greater increases in excess cost, averaging $110 007 for the 62 patients with 3 or more complications. Costs exceeded reimbursement to a much greater degree in those in whom any of the 6 complications developed.Conclusion:Expected hospital costs can be estimated using admission clinical data. Each of 6 complications was associated with enormous increases in costs, indicating their importance as a cause of avoidable expenditures in injury victims and identifying situations in which reimbursement may not be adequate.Arch Surg. 1997;132:920-924This publication has 10 references indexed in Scilit:
- Progress in the development of trauma systems in the United States. Results of a national surveyJAMA, 1995
- A QUANTITATIVE METHOD FOR COST REIMBURSEMENT AND LENGTH OF STAY QUALITY ASSURANCE IN MULTIPLE TRAUMA PATIENTSThe Journal of Trauma and Acute Care Surgery, 1994
- Predicting hospital charge and length of stay for congenital heart disease surgeryThe American Journal of Cardiology, 1993
- Determinants of prolonged length of hospital stay after coronary bypass surgery.Circulation, 1989
- Effect of Pre-existing Disease on Length of Hospital Stay in Trauma PatientsThe Journal of Trauma and Acute Care Surgery, 1989
- Predicting Hospital Charges for Trauma CareArchives of Surgery, 1988
- Reporting the results of epidemiologic studies.American Journal of Public Health, 1986
- Prognosis, Survival, and the Expenditure of Hospital Resources for Patients in an Intensive-Care UnitThe New England Journal of Medicine, 1981
- Survival of adult high-cost patients. Report of a follow-up study from nine acute-care hospitalsJAMA, 1981
- High-Cost Users of Medical CareThe New England Journal of Medicine, 1980