title: The direct economic burden of blunt and penetrating trauma in a managed care population.
abstract: BACKGROUND
  Although the prevalence of trauma in the United States is high, data on the economic burden of this public health problem to third-party payors is limited.
  
  
  METHODS
  Retrospective claims from a large health plan were analyzed for 12,615 adults (age >or=18 years) hospitalized for blunt or penetrating trauma between January 1, 2003 and February 1, 2005. Per patient charges were estimated for resources utilized during a 6-month period before and after initial injury. Continuous health plan enrollment during these periods was required. Three cohorts were examined: isolated traumatic brain injury (TBI); other trauma with TBI (trauma w/TBI); and other trauma without TBI (trauma w/o TBI). Patients were also stratified by Injury Severity Score (ISS) and trauma designation of the admitting hospital.
  
  
  RESULTS
  Initial hospitalization charges ranged from $32,627 for isolated TBI to $103,667 for trauma w/TBI. Charges for initial hospitalization were highest ($199,443) among patients with the most severe injuries. Overall, initial hospitalization charges were highest among those admitted to Level I trauma centers ($68,626); for trauma w/TBI, however, initial hospitalization charges were highest among those admitted to nontrauma centers ($130,997). Charges incurred during postdischarge medical encounters ranged from $16,361 for isolated TBI to $23,761 for trauma w/TBI. Increased charges for postdischarge encounters compared with the 6-month preinjury period ranged from $6,756 for isolated TBI to $19,771 for trauma w/TBI.
  
  
  CONCLUSIONS
  The economic burden of blunt and penetrating trauma to third-party payors is high. Efforts to reduce the incidence of trauma may result in substantial economic savings to managed care systems.
authors.affiliation: RTI Health Solutions, NC 27709, USA. kldavis@rti.org
authors.forename: Keith L
authors.initials: KL
authors.lastname: Davis
authors.forename: Ashish V
authors.initials: AV
authors.lastname: Joshi
authors.forename: Bartholomew J
authors.initials: BJ
authors.lastname: Tortella
authors.forename: Sean D
authors.initials: SD
authors.lastname: Candrilli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics; D001930:Brain Injuries / Q000150:complications / Q000191:economics / Q000628:therapy; D016527:Drug Costs; D005260:Female; D005102:Health Expenditures; D017722:Hospital Charges; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D015601:Injury Severity Score; D007349:Insurance, Health, Reimbursement / Q000191:economics*; D008297:Male; D008329:Managed Care Programs / Q000191:economics*; D008875:Middle Aged; D014193:Trauma Centers / Q000191:economics; D014481:United States; D014949:Wounds, Nonpenetrating / Q000191:economics* / Q000628:therapy; D014950:Wounds, Penetrating / Q000191:economics* / Q000628:therapy