The direct economic burden of blunt and penetrating trauma in a managed care population
The direct economic burden of blunt and penetrating trauma in a managed care population
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DOI：
10.1097/ta.0b013e318031afe3
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发表时间：
2007-03-01
影响因子：
--
通讯作者：
Candrilli, Sean D.
中科院分区：
文献类型：
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作者：
Davis, Keith L.;Joshi, Ashish V.;Candrilli, Sean D.
背景资料：虽然在美国创伤的患病率很高，这一公共卫生问题的经济负担的数据，第三方payors.Methods：回顾性索赔从一个大型健康计划进行了分析，为12,615成人（年龄>= 18岁）住院钝性或穿透性创伤2003年1月1日至2005年2月1日。每名患者的费用估计在6个月期间使用的资源之前和之后的初始损伤。在这些期间，需要连续的健康计划登记。检查了三个队列：单独的创伤性脑损伤（TBI）;其他创伤伴TBI（创伤伴TBI）;和其他创伤不伴TBI（创伤不伴TBI）。患者还分层损伤严重程度评分（ISS）和创伤指定的入院hospital.Results：初始住院费用范围从32,627美元孤立的TBI到103,667美元创伤w/TBI。受伤最严重的病人的初次住院费用最高（199 443美元）。总体而言，在一级创伤中心入院的患者中，初始住院费用最高（68，626美元）;然而，对于创伤合并TBI的患者，在非创伤中心入院的患者中，初始住院费用最高（130，997美元）。在出院后医疗接触期间发生的费用从16,361美元的孤立TBI到23,761美元的创伤/TBI不等。出院后遭遇的6个月受伤前期间相比，增加收费范围从$6，756孤立TBI的创伤W/TBI.Conclusions：钝性和穿透性创伤的第三方付款人的经济负担是很高的。减少创伤发生率的努力可能会为管理式护理系统节省大量的经济开支。
Background: Although the prevalence of trauma in the United States is high, data on the economic burden of this public health problem to third-party payors is limited.Methods: Retrospective claims from a large health plan were analyzed for 12,615 adults (age >= 18 years) hospitalized for blunt or penetrating trauma between January 1, 2003 and February 1, 2005. Per patient charges were estimated for resources utilized during a 6-month period before and after initial injury. Continuous health plan enrollment during these periods was required. Three cohorts were examined: isolated traumatic brain injury (TBI); other trauma with TBI (trauma w/TBI); and other trauma without TBI (trauma w/o TBI). Patients were also stratified by Injury Severity Score (ISS) and trauma designation of the admitting hospital.Results: Initial hospitalization charges ranged from $32,627 for isolated TBI to $103,667 for trauma w/TBI. Charges for initial hospitalization were highest ($199,443) among patients with the most severe injuries. Overall, initial hospitalization charges were highest among those admitted to Level I trauma centers ($68,626); for trauma w/TBI, however, initial hospitalization charges were highest among those admitted to nontrauma centers ($130,997). Charges incurred during postdischarge medical encounters ranged from $16,361 for isolated TBI to $23,761 for trauma w/TBI. Increased charges for postdischarge encounters compared with the 6-month preinjury period ranged from $6,756 for isolated TBI to $19,771 for trauma w/TBI.Conclusions: The economic burden of blunt and penetrating trauma to thirdparty payors is high. Efforts to reduce the incidence of trauma may result in substantial economic savings to managed care systems.