Citation

Dinh MM, McNamara K, Bein KJ, Roncal S, Barnes EH, McBride K, Byrne CM. ANZ J. Surg. 2013; 83(1-2): 60-64.

Affiliation

Department of Trauma Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.

Copyright

(Copyright © 2013, Royal Australasian College of Surgeons, Publisher John Wiley and Sons)

DOI

10.1111/j.1445-2197.2012.06177.x

PMID

22882734

Abstract

OBJECTIVE: This study aimed to determine the relative effect of elderly patients and increasing injury severity on acute hospital costs and inpatient length of stay. METHODS: A prospective study of all trauma team activations at a single inner city trauma centre was conducted over a 1-year period. Costs were imputed using Australian Refined Diagnosis-Related Groups. Costs and inpatient length of stays were compared between elderly (age ≥65 years) and non-elderly patients. Relative effects of increasing injury severity score (ISS) and age categories were modelled using generalized linear regression. RESULTS: Over the study period, 1096 consecutive patients were studied. Falls were the most common mechanism and contributed the highest proportion of aggregate costs. There was a moderately high correlation between cost and ISS (Spearman's rank correlation coefficient 0.65, P < 0.001). Median costs for elderly patients were around three times higher than that for non-elderly patients and median length of stay was over twice that of non-elderly patients (7 days versus 3 days, P < 0.001). After adjusting for injury severity, the predicted costs of elderly trauma patients were around 30% higher compared with non-elderly patients. An increasing effect of injury severity on cost was observed across minor and major trauma. CONCLUSION: Both injury severity and elderly patients have a significant impact on acute hospital costs across the spectrum of major and minor trauma.

Language: en