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Cost factors in pediatric trauma
Dolunay Gürses1, Akile Sarioglu-Buke, Merve Baskan
1Department of Pediatrics, Pamukkale University Faculty of Medicine, Denizli, Turkey. dolunayk@yahoo.com
Insights
The cost of pediatric trauma care is substantial in developing countries. Trauma scores and admission data can help predict these high costs for injured children.
Area of Science:
- Pediatric Emergency Medicine
- Health Economics
- Trauma Surgery
Background:
- Limited data exists on the financial burden of pediatric trauma in developing nations.
- This study addresses the cost factors and predictors of pediatric trauma care in a Turkish university hospital.
Purpose of the Study:
- To prospectively investigate the cost factors associated with treating pediatric trauma.
- To identify predictors of treatment costs in a pediatric emergency setting.
Main Methods:
- A prospective study involving 91 children with multiple trauma was conducted.
- Data collected included demographics, injury details, treatment type, length of stay, and trauma scores (Pediatric Trauma Score, Revised Trauma Score, pediatric Glasgow Coma Scale).
- Hospital-based costs were calculated according to Ministry of Health guidelines.
Main Results:
- Motor vehicle crashes were the most frequent cause of injury (45%), incurring higher costs than falls or bicycle accidents.
- Referred patients had significantly higher costs than directly admitted patients.
- Total cost correlated with hospital stay duration and distance, but inversely with trauma scores.
Conclusions:
- Pediatric trauma treatment incurs significant costs.
- Admission data and established trauma scores can predict the financial impact of pediatric trauma.
Introduction:
There is a lack of information on the cost of treating trauma in children in developing countries. Therefore, in the pediatric emergency unit of a university hospital in Turkey, we prospectively investigated the cost factors of pediatric trauma and attempted to identify cost predictors.
Methods:
We prepared questionnaires and charts for 91 children (50 boys, 41 girls) admitted with multiple trauma to obtain data on age, gender, date and mechanism of injury, site of injury, type of the treatment and length of hospital stay. We studied the physical findings, Pediatric Trauma Score (PTS), Revised Trauma Score (RETS) and pediatric Glasgow Coma Scale (GCS) score, and we totalled all hospital-based costs according to Ministry of Health guidelines.
Results:
The mean (and standard deviation [SD]) age of the children was 79.4 (52.3) months. Motor vehicle crashes accounted for 45% of the injuries, followed by falls (41%) and bicycle accidents (14%). The mean (and SD) total cost of care was US dollar 376.60 (dollar 428.20) (range from dollar 20-dollar 1995). The cost associated with motor vehicle crashes was higher than that for the other injury types (p < 0.05). Seventeen patients required major and 27 patients required minor surgical treatment, whereas 44 patients were treated conservatively; 3 died. Forty-eight percent of patients were referred from another hospital, and the cost of care of referred patients was significantly higher than for those admitted directly (p < 0.001). The mean (and SD) duration of hospital stay was 98 (150) hours. Total cost correlated directly with the duration of hospital stay and distance of the referred hospital or accident scene from our hospital (p < 0.001, r = 0.827 and 0.374 respectively), but the cost correlated inversely with the PTS, the RETS and the pediatric GCS score (p < 0.001, r = -0.339, -0.301 and -0.453 respectively).
Conclusion:
Our findings indicate that the cost of pediatric trauma is high and may be predicted from admission data and trauma scores.
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