@article{ref1,
title="Financial implications of trauma patients at a Canadian level 1 trauma center: a retrospective cohort study",
journal="Trauma surgery and acute care open",
year="2020",
author="Figueira, Sonshire and Fontebasso, Adam M. and Lampron, Jacinthe and Glen, Peter and Thavorn, Kednapa and Matar, Maher",
volume="5",
number="1",
pages="e000568-e000568",
abstract="BACKGROUND: Trauma is a cause of significant morbidity and mortality globally, and patients with major trauma require specialized settings for multidisciplinary care. We sought to enumerate the variability of costs of caring for patients at a Canadian  level 1 trauma center. <br><br>METHODS: A retrospective analysis of all adult patients  admitted to The Ottawa Hospital trauma service between June 2013 and June 2018 was  conducted. Hospital costs and clinical data were collected. Descriptive statistics  and multivariable regression analysis using generalized linear model were performed  to assess cost variation with patient characteristics. Quintile-based analyses were  used to characterize patients in different cost categories. Hospital costs were  reported in 2018 Canadian dollars. <br><br>RESULTS: A total of 2381 admissions were  identified in the 5-year cohort. The mean age of patients was 50.2 years, the mean  Injury Severity Score (ISS) was 18.7, the mean Charlson Comorbidity Index (CCI)  score was 0.35, and the median total cost was $10 048.54. ISS and CCI score were  associated with higher costs (ISS >15; p<0.0001). The most expensive mechanisms of  injury (MOIs) were those involving heavy machinery (median total cost $24 074.38),  pedestrians involved in road traffic collisions ($20 965.45), patients in motor  vehicle collisions ($17 621.01) and motorcycle collisions ($16 220.89), and acts of  self-injury ($13 903.69). Patients who experienced in-hospital adverse events were  associated with higher costs (p<0.0001). Our multivariable regression analysis  showed variation in costs related to male gender, penetrating/violent MOI, ISS,  adverse hospital events, CCI score, urgent admission status, hospital 1-year  mortality risk score, and alternate level of care designation (p<0.05). Quintile-based analyses demonstrated clinically significant differences between the  highest and lowest cost groups. <br><br>DISCUSSION: Major trauma was associated with high  hospital costs. Modifiable and non-modifiable patient factors were shown to  correlate with differing total hospital costs. These findings can aid in the  development of funding strategies and resource allocation for this complex patient  population. LEVEL OF EVIDENCE: Level III evidence for economic and value-based  evaluations.<p /> <p>Language: en</p>",
language="en",
issn="2397-5776",
doi="10.1136/tsaco-2020-000568",
url="http://dx.doi.org/10.1136/tsaco-2020-000568"
}