Citation

David V, Darrell G, Thorpe RJ, Renan C. J. Trauma Acute Care Surg. 2015; 80(2): 258-264.

Affiliation

University of Wisconsin, Population Health, Madison WI 53711, dvanness@wisc.edu Johns Hopkins University, Health Policy and Management, Baltimore, MD 21205, dgaskin1@jhu.edu Johns Hopkins University, Health, Behavior and Society, Baltimore, MD 21205, rthorpe@jhu.edu Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, rcastil1@jhu.edu.

Copyright

(Copyright © 2015, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000000910

PMID

26517784

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 utilized a nationally representative sample to evaluate the association between injuries and health expenditures among a nationally representative U.S.

METHODS: This study used years 2006-2010 (panels 11-14; N=53,065) of the Medical Expenditure Panel Survey (MEPS). Each panel was followed for two 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 non-injured populations controlling for confounding effects.

RESULTS: 4,210 (7.9%) individuals reported injuries representing 21.5 million individuals. Injured individuals were more likely to be males, 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% 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 around $4 billion.

CONCLUSIONS: Injuries pose a substantial burden on medical expenditures in the U.S. 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, thus facilitate engagement of the public in prevention. LEVEL OF EVIDENCE: Level II Economic & Evaluation study.

Language: en