title: Cost Analysis of 48 Burn Patients in a Mass Casualty Explosion Treated at Chang Gung Memorial Hospital.
abstract: BACKGROUND
  Little is known about the costs of treating burn patients after a mass casualty event. A devastating Color Dust explosion that injured 499 patients occurred on June 27, 2015 in Taiwan. This study was performed to investigate the economic effects of treating burn patients at a single medical center after an explosion disaster.
  
  
  METHODS
  A detailed retrospective analysis on 48 patient expense records at Chang Gung Memorial Hospital after the Color Dust explosion was performed. Data were collected during the acute treatment period between June 27, 2015 and September 30, 2015. The distribution of cost drivers for the entire patient cohort (n=48), patients with a percent total body surface area burn (%TBSA)≥50 (n=20), and those with %TBSA <50 (n=28) were analyzed.
  
  
  RESULTS
  The total cost of 48 burn patients over the acute 3-month time period was $2,440,688, with a mean cost per patient of $50,848 ±36,438. Inpatient ward fees (30%), therapeutic treatment fees (22%), and medication fees (11%) were found to be the three highest cost drivers. The 20 patients with a %TBSA ≥50 consumed $1,559,300 (63.8%) of the total expenses, at an average cost of $77,965±34,226 per patient. The 28 patients with a %TBSA <50 consumed $881,387 (36.1%) of care expenses, at an average cost of $31,478±23,518 per patient.
  
  
  CONCLUSIONS
  In response to this mass casualty event, inpatient ward fees represented the largest expense. Hospitals can reduce this fee by ensuring wound dressing and skin substitute materials are regionally stocked and accessible. Medication fees may be higher than expected when treating a mass burn cohort. In preparation for a future event, hospitals should anticipate patients with a %TBSA≥50 will contribute the majority of inpatient expenses.
authors.affiliation: Section of Plastic Surgery, Department of Surgery, The University of Michigan Medical School, United States.
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Mathews
authors.affiliation: Department of Plastic and Reconstructive Surgery, Center for Tissue Engineering, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taiwan.
authors.forename: Ming-Huei
authors.initials: MH
authors.lastname: Cheng
authors.affiliation: University of Michigan Medical School, United States.
authors.forename: John-Michael
authors.initials: JM
authors.lastname: Muller
authors.affiliation: Department of Plastic and Reconstructive Surgery, Center for Tissue Engineering, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taiwan.
authors.forename: Miffy Chia-Yu
authors.initials: MC
authors.lastname: Lin
authors.affiliation: Section of Plastic Surgery, Department of Surgery, The University of Michigan Health System, United States.
authors.forename: Kate W C
authors.initials: KW
authors.lastname: Chang
authors.affiliation: Section of Plastic Surgery, Department of Surgery, The University of Michigan Medical School, United States. Electronic address: kecchung@med.umich.edu.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Chung
mesh_terms: D000293:Adolescent; D000328:Adult; D000698:Analgesia; D001753:Blast Injuries / Q000191:economics / Q000628:therapy*; D002053:Burn Units / Q000191:economics*; D002056:Burns / Q000191:economics* / Q000628:therapy; D003422:Critical Care / Q000191:economics*; D005107:Explosions / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D006761:Hospitals; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D054527:Mass Casualty Incidents / Q000191:economics*; D012189:Retrospective Studies; D017768:Skin, Artificial; D013624:Taiwan; D055815:Young Adult
keywords: Burn care; Burns; Cost Analysis; Inpatient hospitalization; Mass casualty