title: Estimating annual medical and out-of-pocket expenditures associated with traumatic injuries in the United States.
abstract: BACKGROUND
  Every year, as many as 31 million Americans sustain traumatic injuries, leaving survivors with risks of disabilities and health settings with staggering medical costs. Little is known on the societal burden of injuries in terms of medical and out-of-pocket expenditures. Therefore, we used a nationally representative sample to evaluate the association between injuries and health expenditures among a nationally representative US sample.
  
  
  METHODS
  This study used years 2006 to 2010 (Panels 11-14; n = 53,065) of the Medical Expenditure Panel Survey. Each panel was followed up for 2 years. Total expenditures included insurance payments and out-of-pocket costs. Two-part models were constructed to examine differences in annual medical expenditures between injured and noninjured populations controlling for confounding effects.
  
  
  RESULTS
  A total of 4,210 individuals (7.9%) reported injuries representing 21.5 million individuals. Injured individuals were more likely to be males, to be white, and to report higher medical expenditures in the second year than the reference population (p < 0.01). Adjusted analyses showed that reporting any injury was associated with $2,577 (95% confidence interval [CI], $2,049-$3,103) and $186 (95% CI, $142-$230) increase in total and out-of-pocket costs, respectively. While a moderate or severe injury was associated with $4,779 (95% CI, $3,947-$5,610) increase in the average of medical expenditures and $256 (95% CI, $190-$322) increase in out-of-pocket costs adjusting for covariates. Our adjusted national medical cost of injuries was estimated at $56 billion and out-of-pocket cost to be approximately $4 billion.
  
  
  CONCLUSIONS
  Injuries pose a substantial burden on medical expenditures in the United States. Investment in injury prevention can facilitate reducing medical expenditures and save resources. Prevention programs may use the out-of-pocket findings to highlight injury burden on individual's prosperity and thus facilitate engagement of the public in prevention.
  
  
  METHODS
  Economic and evaluation study, level III.
authors.affiliation: From the Department of Health Policy and Management (S.A., R.C.), Johns Hopkins Bloomberg School of Public Health; and Health Policy and Management (D.G.), and Health, Behavior and Society (R.T.), Johns Hopkins University, Baltimore, Maryland; and Population Health (D.V.), University of Wisconsin, Madison, Wisconsin.
authors.forename: Suliman
authors.initials: S
authors.lastname: Alghnam
authors.forename: David J
authors.initials: DJ
authors.lastname: Vanness
authors.forename: Darrell J
authors.initials: DJ
authors.lastname: Gaskin
authors.forename: Roland J
authors.initials: RJ
authors.lastname: Thorpe
authors.forename: Renan
authors.initials: R
authors.lastname: Castillo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D005249:Fees and Charges; D005260:Female; D019538:Health Care Surveys; D005102:Health Expenditures; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D055815:Young Adult