title: The financial cost of treating polytrauma: implications for tertiary referral centres in the United Kingdom.
abstract: This observational study was designed to evaluate the financial cost and resources needed to treat a polytrauma patient at a tertiary care centre in the United Kingdom. Sixty-nine patients, from outside the normal hospital catchment area, were referred to a University Hospital and treated for polytrauma (injury severity score>15). Fifty-one patients had head injuries in addition to other injuries. Fourteen patients died in hospital. Forty-seven patients spent 316 ITU days with a total of 832 hospital days. One hundred and ninety-six operating hours were used for their surgical treatment and only 13 patients required neurosurgical intervention. There were 580 radiological and 2967 blood investigations. The total cost of treating these patients was 974,874 pounds. The money received by the hospital from the respective primary care trusts was an average of 1500 pounds per patient for the full treatment including follow up. Thus, the fiscal deficit was 871,375 pounds. This study indicates that the financial accounting for complex cases is antiquated and inaccurate within the NHS. Tertiary referral centres receive only 10% of the appropriate money for treatment of polytrauma patients. The number of patients is relatively small, but their impact on the local services is very high.
authors.affiliation: Queen's Medical Centre-University Hospital, Nottingham, UK.
authors.forename: M
authors.initials: M
authors.lastname: Sikand
authors.forename: K
authors.initials: K
authors.lastname: Williams
authors.forename: C
authors.initials: C
authors.lastname: White
authors.forename: C G
authors.initials: CG
authors.lastname: Moran
mesh_terms: D000066:Accounting / Q000379:methods; D006259:Craniocerebral Trauma / Q000191:economics / Q000628:therapy; D003422:Critical Care / Q000191:economics; D004739:England; D005381:Financing, Organized / Q000379:methods; D017048:Health Care Costs; D006801:Humans; D007902:Length of Stay; D009104:Multiple Trauma / Q000191:economics* / Q000401:mortality / Q000628:therapy; D012017:Referral and Consultation; D013222:State Medicine / Q000191:economics; D014193:Trauma Centers / Q000191:economics*