title: Pharmacoeconomic evaluation of treatment of penetrating abdominal trauma.
abstract: The hospital, pharmacy, and antibiotic costs for patients with penetrating abdominal trauma were compared with reimbursement received; these costs were also analyzed to assess the potential impact of a total prospective pricing system (PPS). During a four-year period, 46 patients admitted solely for penetrating abdominal trauma were retrospectively evaluated: their discharge summaries indicated that, for 9 patients, reimbursement was based on diagnosis-related groups (DRGs) under the PPS; 9 patients had private insurance; and 28 were classified as "self-paying/no insurance." All costs, corrected for inflation, were reported in 1989 dollars. Antibiotics represented 22.5%, 1.7%, and 0.5% of pharmacy, hospital, and DRG reimbursement, respectively; pharmacy costs were 8.5% of hospital costs and 2.3% of DRG reimbursement. For all 46 patients, a net loss of $295 per patient was incurred. Four patients accounted for 43% of the hospital costs. If the hospital had been reimbursed for all of these patients by prospective pricing and DRGs, it would have had a median profit of $9730 in 42 of 46 patients. Costs exceeded DRG reimbursement in the remaining four patients by a median of $8210. Antibiotic costs and pharmacy costs represent a small portion of hospital costs and DRG reimbursement for patients with penetrating abdominal trauma; thus, cost containment efforts in these patients should be directed at other ancillary services and length of stay.
authors.affiliation: College of Pharmacy, Medical University of South Carolina, Charleston 29425-0810.
authors.forename: L V
authors.initials: LV
authors.lastname: Friedrich
authors.forename: R L
authors.initials: RL
authors.lastname: White
authors.forename: M B
authors.initials: MB
authors.lastname: Kays
authors.forename: D S
authors.initials: DS
authors.lastname: Burgess
mesh_terms: D000007:Abdominal Injuries / Q000188:drug therapy / Q000191:economics* / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use; D016527:Drug Costs / Q000706:statistics & numerical data; D004363:Drug Utilization; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006746:Hospital Bed Capacity, 500 and over; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016311:Outliers, DRG; D012189:Retrospective Studies; D013022:South Carolina; D014950:Wounds, Penetrating / Q000188:drug therapy / Q000191:economics* / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents