Citation

Christensen MC, Ridley S, Lecky FE, Munro V, Morris S. Crit. Care 2008; 12(1): R23.

Copyright

(Copyright © 2008, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/cc6797

PMID

18298813

PMCID

PMC2374581

Abstract

BACKGROUND: Trauma represents an important public health concern in the UK, yet the acute costs of blunt trauma have not been documented and analysed in detail. Knowledge of the overall costs of trauma care, and the drivers of these costs, is a prerequisite for a cost-conscious approach to improvement in standards of trauma care, including evaluation of the cost-effectiveness of new health care technologies. METHODS: Using the Trauma Audit Research Network (TARN) database, we examined inpatient records for persons aged 18+ years hospitalised for blunt trauma between January 2000 and December 2005. Patients were stratified by Injury Severity Score (ISS). RESULTS: 35,564 patients were identified; 60% with ISS 0-9, 17% ISS 10-16, 12% ISS 17-25, and 11% with ISS 26-75. The median age was 46 years and 63% of patients were men. Falls were the most common cause of injury (50%), followed by road traffic collisions (33%). Twenty-nine percent were admitted to critical care for a median length of stay of 4 days. Median total hospital length of stay was 9 days, and 69% of patients underwent at least one surgical procedure. Seven percent of the patients died before discharge with the highest proportion of deaths among those in the ISS 26-75 group (32%). The mean hospital cost per person was GBP 9,530. Costs varied significantly by Glasgow Coma Score, Injury Severity Score, age, cause of injury, type of injury, hospital mortality, grade and specialty of doctor seen in A&E, and year of admission. CONCLUSION: The acute treatment costs of blunt trauma in England and Wales vary significantly by injury severity and survival and public health initiatives that aim to reduce both the incidence and severity of blunt trauma are likely to produce significant savings in acute trauma care. The largest component of acute hospital cost is determined by length of stay and measures designed to reduce length of admissions are likely to be more effective than other measures at reducing the costs of blunt trauma care.

Language: en