Details
| Translated title of the contribution | Evaluation of costs incurred for patients with multiple trauma particularly from the perspective of the hospital |
|---|---|
| Original language | German |
| Pages (from-to) | 563-574 |
| Number of pages | 12 |
| Journal | UNFALLCHIRURG |
| Volume | 107 |
| Issue number | 7 |
| Early online date | 4 Jun 2004 |
| Publication status | Published - Jul 2004 |
Abstract
The aim of this study was to evaluate the costs involved in treating severely injured patients at the clinic differentiated by several characteristics (injury, age), sectors (emergency room, surgery, intensive and normal care), and kinds of costs (fixed costs, variable costs) and to determine influencing factors regarding costs based on the register of the DGU (Deutsche Gesellschaft für Unfallchirurgie). All patients were taken into account who had an injury severity score (ISS) of at least 16. On this basis costs of 3702 patients were analyzed. They were compared by using analysis of variance for different groups of patients classified according to kind of injury, severity of injury, and age. Moreover, multiple regression was performed to control the common influence of demographic factors and the type of injury on costs. The average ISS of the analyzed patients was 30.6 (±11.6) points. The average costs of the clinic were 32,166 (±25,404) EUR per patient. More than half of the costs was incurred by intensive care and about one-fourth by surgery. On average 30.6% were variable costs and 69.4% were fixed costs. The analysis of variance revealed that costs increased with advancing age and severity of injury (ISS). Multiple regression confirmed these interrelations indicating that extremities are very cost intensive. Due to the high portion of fixed costs, the overall costs strongly depend on the capacity utilization and less on hospital stay. That is why it may be necessary in the future to create centers for trauma care to maintain economic efficiency for treatment of these patients. Besides large differences of costs within closely defined groups of patients, hospitals carry a high economic risk so that a more complex reimbursement system should be discussed than implemented by the German DRGs.
ASJC Scopus subject areas
- Medicine(all)
- Surgery
- Medicine(all)
- Emergency Medicine
- Medicine(all)
- Orthopedics and Sports Medicine
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In: UNFALLCHIRURG, Vol. 107, No. 7, 07.2004, p. 563-574.
Research output: Contribution to journal › Article › Research › peer review
}
TY - JOUR
T1 - Evaluation der Kosten von polytraumatisierten Patienten insbesondere aus der Perspektive des Krankenhauses
AU - AG Polytrauma der DGU
AU - Schwermann, T.
AU - Grotz, M.
AU - Blanke, M.
AU - Ruchholtz, S.
AU - Lefering, R.
AU - Schulenburg, J. M.Graf V.D.
AU - Krettek, C.
AU - Pape, H. C.
PY - 2004/7
Y1 - 2004/7
N2 - The aim of this study was to evaluate the costs involved in treating severely injured patients at the clinic differentiated by several characteristics (injury, age), sectors (emergency room, surgery, intensive and normal care), and kinds of costs (fixed costs, variable costs) and to determine influencing factors regarding costs based on the register of the DGU (Deutsche Gesellschaft für Unfallchirurgie). All patients were taken into account who had an injury severity score (ISS) of at least 16. On this basis costs of 3702 patients were analyzed. They were compared by using analysis of variance for different groups of patients classified according to kind of injury, severity of injury, and age. Moreover, multiple regression was performed to control the common influence of demographic factors and the type of injury on costs. The average ISS of the analyzed patients was 30.6 (±11.6) points. The average costs of the clinic were 32,166 (±25,404) EUR per patient. More than half of the costs was incurred by intensive care and about one-fourth by surgery. On average 30.6% were variable costs and 69.4% were fixed costs. The analysis of variance revealed that costs increased with advancing age and severity of injury (ISS). Multiple regression confirmed these interrelations indicating that extremities are very cost intensive. Due to the high portion of fixed costs, the overall costs strongly depend on the capacity utilization and less on hospital stay. That is why it may be necessary in the future to create centers for trauma care to maintain economic efficiency for treatment of these patients. Besides large differences of costs within closely defined groups of patients, hospitals carry a high economic risk so that a more complex reimbursement system should be discussed than implemented by the German DRGs.
AB - The aim of this study was to evaluate the costs involved in treating severely injured patients at the clinic differentiated by several characteristics (injury, age), sectors (emergency room, surgery, intensive and normal care), and kinds of costs (fixed costs, variable costs) and to determine influencing factors regarding costs based on the register of the DGU (Deutsche Gesellschaft für Unfallchirurgie). All patients were taken into account who had an injury severity score (ISS) of at least 16. On this basis costs of 3702 patients were analyzed. They were compared by using analysis of variance for different groups of patients classified according to kind of injury, severity of injury, and age. Moreover, multiple regression was performed to control the common influence of demographic factors and the type of injury on costs. The average ISS of the analyzed patients was 30.6 (±11.6) points. The average costs of the clinic were 32,166 (±25,404) EUR per patient. More than half of the costs was incurred by intensive care and about one-fourth by surgery. On average 30.6% were variable costs and 69.4% were fixed costs. The analysis of variance revealed that costs increased with advancing age and severity of injury (ISS). Multiple regression confirmed these interrelations indicating that extremities are very cost intensive. Due to the high portion of fixed costs, the overall costs strongly depend on the capacity utilization and less on hospital stay. That is why it may be necessary in the future to create centers for trauma care to maintain economic efficiency for treatment of these patients. Besides large differences of costs within closely defined groups of patients, hospitals carry a high economic risk so that a more complex reimbursement system should be discussed than implemented by the German DRGs.
KW - Costs of patients with multiple injuries
KW - Different characteristics
KW - Injury severity score
KW - Sectors
KW - Types of costs
UR - http://www.scopus.com/inward/record.url?scp=4344634879&partnerID=8YFLogxK
U2 - 10.1007/s00113-004-0778-y
DO - 10.1007/s00113-004-0778-y
M3 - Artikel
C2 - 15179555
AN - SCOPUS:4344634879
VL - 107
SP - 563
EP - 574
JO - UNFALLCHIRURG
JF - UNFALLCHIRURG
SN - 0177-5537
IS - 7
ER -