OBJECTIVE: Few studies have examined direct economic burden of traumatic injury. In this study, we estimated total per-patient charges for healthcare resources consumed by patients with blunt or penetrating trauma in a population of US managed care organization (MCO) enrollees.
METHODS: Retrospective claims from the Ingenix MCO database were analyzed for 14,841 patients hospitalized for blunt or penetrating trauma between 1/1/03 and 2/1/05. Study subjects had °Ý 6 months of health plan enrollment prior to and following initial injury. Three cohorts were identified based on published definitions for claims data: isolated traumatic brain injury (TBI); other blunt or penetrating trauma with TBI; and other blunt or penetrating trauma without TBI. Per-patient charges for all health care resources utilized over a 6-month period following initial injury were estimated. Baseline patient characteristics examined included mean age and Injury Severity Score (ISS) at initial injury, as well as mean Charlson Comorbidity Index (CCI) for the 6-month period prior to initial injury.
RESULTS: Among those with isolated TBI (N=3,028, age=38.17, ISS=10.06, CCI=0.69), mean per-patient charges incurred during the index hospitalization were $30,333; mean per-patient charges incurred during post-discharge encounters were $4,606 for subsequent hospitalizations, $764 for pharmaceuticals, and $7,658 for outpatient and other ancillary care. Among those with other trauma and TBI (N=2,726, age=37.53, ISS=18.28, CCI=0.44), these mean charges were $101,189, $6,018, $726, and $14,599, respectively. Among those with other trauma but without TBI (N=9,087, age=50.09, ISS=8.90, CCI=1.08), these mean charges were $42,509, $6,443, $1,102, and $10,952, respectively.
CONCLUSION: Charges incurred during the index hospitalization were 39% higher among patients with both TBI and other trauma compared to the other cohorts combined. When examining total charges, the premium for combination trauma was > 17%. Results of this study illustrate and underscore the significant direct economic burden associated with combined systemic and TBI injury.
