title: Methamphetamine use is associated with increased hospital resource consumption among minimally injured trauma patients.
abstract: BACKGROUND
  The clinical effects of methamphetamines (MA) may complicate medical management, potentially increasing resource utilization and hospital costs out of proportion to the patient's severity of injury. We hypothesize that minimally injured (MI) patients testing positive for MA consume more resources than patients testing negative for MA.
  
  
  METHODS
  Adult trauma patients were identified from 4 years of registry data, which was linked to cost data from our center's financial department. Patients were classified as MI (Injury Severity Score <9) or severely injured (Injury Severity Score >9). Primary outcome was total direct costs for the inpatient hospital stay. Secondary outcomes included direct costs by cost center, contribution margin, and hospital length of stay.
  
  
  RESULTS
  Sixty-five percent (n = 6,193) of the 10,663 adult patients during the study period were admitted with MI. Nine percent (n = 557) of those tested were positive for MA. Total direct costs were higher in MI MA patients compared to nonusers ($2,998 vs. $2,667, p < 0.001), and users consumed more resources in all 10 cost centers. The same multivariate model showed marginally increased costs with MI alcohol users, but not with MI cocaine users or severely injured MA users.
  
  
  CONCLUSIONS
  MI MA patients consume more resources than patients testing negative for MA. Although MA use complicates the initial evaluation of patients, resource consumption was increased for all cost centers representing the entirety of a patients hospital stay, suggesting that the influence of MA is not limited to the initial diagnostic workup. Centers with high proportions of MA users may realize significant losses if compensation contracts are inadequate.
authors.affiliation: Department of Surgery, Division of Trauma and Emergency Surgery, University of California, Davis, Sacramento, California 95817, USA. jason.london@ucdmc.ucdavis.edu
authors.forename: Jason A
authors.initials: JA
authors.lastname: London
authors.forename: Garth H
authors.initials: GH
authors.lastname: Utter
authors.forename: Felix
authors.initials: F
authors.lastname: Battistella
authors.forename: David
authors.initials: D
authors.lastname: Wisner
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data*; D006801:Humans; D013287:Illicit Drugs / Q000633:toxicity*; D015601:Injury Severity Score; D007902:Length of Stay / Q000191:economics*; D008297:Male; D008694:Methamphetamine / Q000633:toxicity*; D010343:Patient Admission / Q000706:statistics & numerical data; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D019966:Substance-Related Disorders / Q000150:complications / Q000191:economics*; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000150:complications / Q000191:economics*
chemical_list: D013287:Illicit Drugs; D008694:Methamphetamine