Comprehensive Analysis of US Health Care Spending on Injuries

Area of Science:

• Health Economics
• Trauma Care
• Public Health Policy

Background:

• Traumatic injuries impact all demographics and care settings in the US.
• Quantifying injury-related healthcare spending across dimensions remains a challenge.

Purpose of the Study:

• To estimate US healthcare spending on injuries in 2022.
• To analyze spending by injury mechanism, payer, and care type.

Main Methods:

• Cross-sectional analysis of over 40 billion claims (Medicare, Medicaid, commercial).
• Spending attributed to injury diagnoses, adjusted for comorbidities.
• Stratified analysis by age, sex, mechanism, payer, and care type.

Main Results:

• Total US injury spending was $106.7 billion in 2022.
• Ambulatory and inpatient care each accounted for 40% of spending; 52% occurred outside acute care.
• Falls were the leading cause ($56.2B), followed by transport injuries ($23.3B).
• Spending phenotypes varied: falls concentrated in older women (post-acute care), while firearms/assault concentrated in younger men (acute care).
• Payer burden differed by mechanism (e.g., falls: 40% Medicare; assault: 52% Medicaid).

Conclusions:

• This comprehensive claims-based analysis reveals nearly $107 billion in annual US injury spending.
• Distinct spending phenotypes by mechanism, demographics, and payer have direct implications for trauma system planning, financing, and sustainability.