Longitudinal analysis of hospital charges following injury in a level 1 pediatric trauma system

Area of Science:

• Pediatric trauma research
• Health economics
• Injury surveillance

Background:

• Pediatric injury treatment represents a substantial financial burden on healthcare systems.
• Understanding these costs is crucial for resource allocation and healthcare policy.

Purpose of the Study:

• To characterize the financial charges associated with traumatic injuries in children at a level-1 pediatric trauma center.
• To identify key factors contributing to the overall cost of pediatric trauma care.

Main Methods:

• Analysis of financial data for pediatric patients (<14 years) admitted for traumatic injuries between January 2009 and December 2014.
• Evaluation of charges during the initial hospital admission and for the first two years post-discharge.
• Utilized a cohort study design (Level II evidence).

Main Results:

• 5853 patients incurred average annual charges of over $11 million.
• Falls (44%), sports (12%), and bike-related incidents (9%) were the most common injury mechanisms.
• Spinal cord and major abdominal injuries incurred the highest per-patient charges during admission ($55,560 and $23,618), largely due to hospital length of stay (LOS).
• Post-discharge, spinal cord injuries led to the highest costs ($19,426) in the first year, primarily due to inpatient rehabilitation.

Conclusions:

• Injury severity, anatomical location of injury, and hospital LOS are major contributors to pediatric trauma costs.
• Inpatient readmissions and rehabilitation significantly increase healthcare charges in the years following initial discharge.
• Defining healthcare outcomes relative to costs is essential for value-based care in pediatric trauma.