National injury-related hospitalizations in children: public versus private expenditures across preventable injury mechanisms.
National injury-related hospitalizations in children: public versus private expenditures across preventable injury mechanisms.
复制标题
全国儿童伤害相关住院治疗：可预防伤害机制中的公共支出与私人支出。
DOI：
10.1097/ta.0b013e31812f5ea7
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Barlow,Barbara
中科院分区：
文献类型：
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作者：
Pressley,JoyceC;Trieu,Lisa;Kendig,Tiffany;Barlow,Barbara
背景：在更普遍的应用领域，有效的伤害预防方法的支出检查可以确定具体的机制和年龄组，有效的干预可能会影响公众伤害相关的expenditures.Methods：医疗保健成本和利用项目2003年（KID-HCUP）包含急性护理住院数据，美国儿童和青少年居住在36个州。研究人群包括240，248名0至19岁未加权（397，943名加权）受伤相关出院者。使用ICDMAP-90和国际损伤严重程度评分分类（ICISS）评估损伤严重程度。采用SUDAAN对分层抽样进行方差调整。支出加权代表美国population.Results：伤害相关的住院治疗（平均$28，137 ± 64，420，中位数$10，808）比非伤害出院费用更高，约占所有住院患者的10%（未加权），但超过五分之一的支出。公共来源是37.7%受伤人员的主要支付者。不同损伤机制的发病率和每例费用差异严重影响了机制具体支出总额。机动车碰撞是私人和公共支付者的最大支出，三分之二的支出用于青少年，超过40%用于司机。医疗补助覆盖了45.6%（1.92亿美元）的烧伤支出和59.2%的0-4岁奥尔兹。每个案件的支出（平均值±SD，中位数）为：火器（36，196 ± 58，052美元，19，020美元），机动车驾驶员（33，731 ± 50，583美元，18，431美元），行人（31,414 ±57,103美元，16,552美元）;烧伤（29，242 ± 64，271美元，10，739美元）;福尔斯（13，069 ± 20，225美元，8，610美元）;以及中毒（8，290 ± 15，462，5，208美元）。结论：在几种可改变的伤害机制中，更普遍地应用已证实的伤害预防有可能减少公共和私人的卫生支出负担。
Background:Examination of expenditures in areas where more universal application of effective injury prevention approaches is indicated could identify specific mechanisms and age groups where effective intervention may impact public injury-related expenditures.Methods:The Healthcare Cost and Utilization Project 2003 (KID-HCUP) contains acute care hospitalization data for US children and adolescents residing in 36 states. The study population includes 240,248 unweighted (397,943 weighted) injury-related hospital discharges for ages 0 to 19 years. Injury severity was assessed using ICDMAP-90 and International Classification of Injury Severity Scores (ICISS). SUDAAN was employed to adjust variances for stratified sampling. Expenditures were weighted to represent the US population.Results:Injury-related hospitalizations (mean $28,137±64,420, median $10,808) were more costly than non-injury discharges, accounting for approximately 10% of all persons hospitalized (unweighted), but more than one-fifth of expenditures. Public sources were the primary payor for 37.7% of injured persons. Incidence and cost per case variations across specific injury mechanisms heavily influenced total mechanism specific expenditures. Motor vehicle crashes were the largest expenditures for private and public payors with two thirds of expenditures in teenagers–more than 40% for drivers. Medicaid covered 45.6%($192 million) of burn expenditures and 59.2% in 0–4 year olds. Expenditures per case (mean±SD, median) were: firearm ($36,196±58,052, $19,020), motor vehicle driver ($33,731±50,583, $18,431), pedestrian ($31,414±57,103, $16,552); burns ($29,242±64,271, $10,739); falls ($13,069±20,225, $8,610); and poisoning ($8,290±$15,462, $5,208).Conclusions:More universal application of proven injury prevention has the potential to decrease both the public and private health expenditure burden among several modifiable injury mechanisms.