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Resource utilization by injured automobile occupants and pedestrians
1Royal Prince Alfred Hospital, Camperdown, New South Wales, Austraila.
Background:
This study was designed to test the hypothesis that the hospital resources utilized in treating pedestrian trauma would be significantly greater than that for automobile occupants. This was based on previous studies that showed that the demographic features and patterns of injury sustained by the pedestrian population were significantly different from that of automobile occupants.
Methods:
A hospital-based study was designed utilizing retrospective analysis of a prospective trauma database. All primary retrievals of pedestrians (n=547) and automobile occupants (n=597) involved in accidents in Central Sydney from mid-1990 to mid-1995 were included. The length of hospital stay, use of the intensive care unit (ICU) and visits to the operating theatre (Standard Resource Cost) were compared.
Results:
The age and injury severity scores were significantly higher for the pedestrian group. The length of stay (days) for the pedestrians (mean, 12 SD 14; median, 7 interquartile range (IQR) 13), was significantly higher (P < 0.0001 ) than that for the automobile occupants (mean, 7 SD 11; median, 2 IQR 6). The ICU utilization (days) for the pedestrians (mean, 1.3 SD 4.0; median, 0) was significantly higher (P < 0.0001) than that of the automobile occupants (mean, 0.6 SD 2.9; median, 0). The average operating theatre utilization per pedestrian (0.65 visits) exceeded that of automobile occupants (0.43) by 50% (P < 0.0001).
Conclusions:
The study confirms that the acute care of pedestrian injury utilizes more hospital resources than that of automobile occupants. Resources should be allocated to meet this need both in terms of hospital reimbursement and overall directives in public health policy.