The effect of regional trauma care systems on costs.
OBJECTIVE
To assess cost savings from regional trauma care systems.


METHODS
Multivariate regression analysis is used to isolate the effects of regional trauma care systems on medical costs while controlling for personal and injury characteristics and other factors likely to influence medical costs. Percentage reductions in costs are translated into dollar cost savings with corrections for excluded costs and losses from premature death.


METHODS
Injuries to workers filing workers' compensation lost workday claims.


METHODS
Randomly sampled workers' compensation claims from 17 states filed between 1979 and 1988 (N = 217,000).


METHODS
Medical payments per episode of four injury groups: lower-extremity fractures and dislocations, upper-extremity fractures and dislocations, other upper-extremity injuries, and back strains and sprains. We distinguish hospitalized from nonhospitalized claims.


RESULTS
Statistical analyses reveal that states with trauma care systems have 15.5% lower costs per hospitalized injury episode. Savings average $1025 per case in 1988 dollars. Costs per episode for disabling nonhospitalized injury are 10% lower in states with trauma care systems, with savings averaging $75 per case. The largest savings are for back injuries.


CONCLUSIONS
Extending trauma care systems nationwide could lower annual medical care payments by $3.2 billion. Including productivity losses due to premature death, the savings could total $10.3 billion, 5.9% of national injury costs.
Miller
T R
TR
Safety and Health Policy Program, National Public Services Research Institute, Landover, Md.
Levy
D T
DT
D001134:Arm Injuries / Q000191:economics; D019567:Back Injuries; D017046:Cost Savings; D003365:Costs and Cost Analysis; D017050:Episode of Care; D050723:Fractures, Bone / Q000191:economics; D005102:Health Expenditures; D006760:Hospitalization / Q000191:economics; D006801:Humans; D004204:Joint Dislocations / Q000191:economics; D007869:Leg Injuries / Q000191:economics; D015999:Multivariate Analysis; D009784:Occupational Diseases / Q000191:economics; D012041:Regional Medical Programs / Q000191:economics*; D012044:Regression Analysis; D013180:Sprains and Strains / Q000191:economics; D014193:Trauma Centers / Q000191:economics*; D014481:United States; D014942:Workers' Compensation / Q000191:economics; D014947:Wounds and Injuries / Q000191:economics*