Document Detail

Long-term survival and return on investment after nonneurologic injury: implications for the elderly trauma patient.
MedLine Citation:
PMID:  20622584     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: As the population of the United States ages and as the healthcare system undergoes significant change, cost effectiveness of care will become more important, particularly for older injured patients. The purpose of this study was to evaluate the cost per 2-year survivor stratified by age after moderate- to severe-nonneurologic injury. METHODS: The trauma registry from a Level I trauma center was queried for adults (older than 18 years), discharged alive after blunt injury (Injury Severity Score >15), without significant neurologic injury, and with hospital charge data. Survival was determined using the Social Security Death Master File. Patients were stratified by age. Hospital costs were calculated by multiplying hospital charge by the cost to charge ratio. RESULTS: One thousand nine hundred fourteen patients made up the study population. Mean hospital cost per patient was $10,021. Mean cost per 2-year survivor was $10,328. Overall 2-year survival was 97%. (*p < 0.05 vs. youngest). When broken down by age group, there were no significant differences in hospital costs. However, 2-year survival was significantly less in those who were 55.1 years to 75 years old and those older than 75 years, when compared with those aged 18 years to 25 years. Thus, median cost per 2-year survivor was highest in those older than 75 years ($8,911). CONCLUSION: Although costs are similar by age at time of discharge, cost per 2-year survivor increases as age increases. However, cost per 2-year survivor does not exceed current cost-utility thresholds for any age group. Any future healthcare financing reforms should include aggressive funding for injury prevention efforts aimed at vulnerable populations instead of rationing care once an injury occurs.
Ben L Zarzaur; Louis J Magnotti; Martin A Croce; Adil H Haider; Timothy C Fabian
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of trauma     Volume:  69     ISSN:  1529-8809     ISO Abbreviation:  J Trauma     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-12     Completed Date:  2010-08-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  93-8     Citation Subset:  AIM; IM    
Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee 38163, USA.
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MeSH Terms
Age Factors
Aged, 80 and over
Hospital Costs / statistics & numerical data
Injury Severity Score
Middle Aged
Retrospective Studies
Trauma Centers / economics,  statistics & numerical data
Wounds and Injuries / economics,  mortality*
Wounds, Nonpenetrating / economics,  mortality
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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