Long-term medical and productivity costs of severe trauma: Results from a prospective cohort study
Through improvements in trauma care there has been a decline in injury mortality, as more people survive severe trauma. Patients who survive severe trauma are at risk of long-term disabilities which may place a high economic burden on society. The purpose of this study was to estimate the health car...
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| Abstract | Through improvements in trauma care there has been a decline in injury mortality, as more people survive severe trauma. Patients who survive severe trauma are at risk of long-term disabilities which may place a high economic burden on society. The purpose of this study was to estimate the health care and productivity costs of severe trauma patients up to 24 months after sustaining the injury. Furthermore, we investigated the impact of injury severity level on health care utilization and costs and determined predictors for health care and productivity costs. This prospective cohort study included adult trauma patients with severe injury (ISS[greater than or equal to]16). Data on in-hospital health care use, 24-month post-hospital health care use and productivity loss were obtained from hospital registry data and collected with the iMTA Medical Consumption and Productivity Cost Questionnaire. The questionnaires were completed 1 week and 1, 3, 6, 12 and 24 months after injury. Log-linked gamma generalized linear models were used to investigate the drivers of health care and productivity costs. In total, 174 severe injury patients were included in this study. The median age of participants was 55 years and the majority were male (66.1%). The mean hospital stay was 14.2 (SD = 13.5) days. Patients with paid employment returned to work 21 weeks after injury. In total, the mean costs per patient were [euro]24,760 with in-hospital costs of [euro]11,930, post-hospital costs of [euro]7,770 and productivity costs of [euro]8,800. Having an ISS [greater than or equal to]25 and lower health status were predictors of high health care costs and male sex was associated with higher productivity costs. Both health care and productivity costs increased with injury severity, although large differences were observed between patients. It is important for decision-makers to consider not only in-hospital health care utilization but also the long-term consequences and associated costs related to rehabilitation and productivity loss. |
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| AbstractList | Background Through improvements in trauma care there has been a decline in injury mortality, as more people survive severe trauma. Patients who survive severe trauma are at risk of long-term disabilities which may place a high economic burden on society. The purpose of this study was to estimate the health care and productivity costs of severe trauma patients up to 24 months after sustaining the injury. Furthermore, we investigated the impact of injury severity level on health care utilization and costs and determined predictors for health care and productivity costs. Methods This prospective cohort study included adult trauma patients with severe injury (ISS[greater than or equal to]16). Data on in-hospital health care use, 24-month post-hospital health care use and productivity loss were obtained from hospital registry data and collected with the iMTA Medical Consumption and Productivity Cost Questionnaire. The questionnaires were completed 1 week and 1, 3, 6, 12 and 24 months after injury. Log-linked gamma generalized linear models were used to investigate the drivers of health care and productivity costs. Results In total, 174 severe injury patients were included in this study. The median age of participants was 55 years and the majority were male (66.1%). The mean hospital stay was 14.2 (SD = 13.5) days. Patients with paid employment returned to work 21 weeks after injury. In total, the mean costs per patient were [euro]24,760 with in-hospital costs of [euro]11,930, post-hospital costs of [euro]7,770 and productivity costs of [euro]8,800. Having an ISS [greater than or equal to]25 and lower health status were predictors of high health care costs and male sex was associated with higher productivity costs. Conclusions Both health care and productivity costs increased with injury severity, although large differences were observed between patients. It is important for decision-makers to consider not only in-hospital health care utilization but also the long-term consequences and associated costs related to rehabilitation and productivity loss. BackgroundThrough improvements in trauma care there has been a decline in injury mortality, as more people survive severe trauma. Patients who survive severe trauma are at risk of long-term disabilities which may place a high economic burden on society. The purpose of this study was to estimate the health care and productivity costs of severe trauma patients up to 24 months after sustaining the injury. Furthermore, we investigated the impact of injury severity level on health care utilization and costs and determined predictors for health care and productivity costs.MethodsThis prospective cohort study included adult trauma patients with severe injury (ISS≥16). Data on in-hospital health care use, 24-month post-hospital health care use and productivity loss were obtained from hospital registry data and collected with the iMTA Medical Consumption and Productivity Cost Questionnaire. The questionnaires were completed 1 week and 1, 3, 6, 12 and 24 months after injury. Log-linked gamma generalized linear models were used to investigate the drivers of health care and productivity costs.ResultsIn total, 174 severe injury patients were included in this study. The median age of participants was 55 years and the majority were male (66.1%). The mean hospital stay was 14.2 (SD = 13.5) days. Patients with paid employment returned to work 21 weeks after injury. In total, the mean costs per patient were €24,760 with in-hospital costs of €11,930, post-hospital costs of €7,770 and productivity costs of €8,800. Having an ISS ≥25 and lower health status were predictors of high health care costs and male sex was associated with higher productivity costs.ConclusionsBoth health care and productivity costs increased with injury severity, although large differences were observed between patients. It is important for decision-makers to consider not only in-hospital health care utilization but also the long-term consequences and associated costs related to rehabilitation and productivity loss. Through improvements in trauma care there has been a decline in injury mortality, as more people survive severe trauma. Patients who survive severe trauma are at risk of long-term disabilities which may place a high economic burden on society. The purpose of this study was to estimate the health care and productivity costs of severe trauma patients up to 24 months after sustaining the injury. Furthermore, we investigated the impact of injury severity level on health care utilization and costs and determined predictors for health care and productivity costs. This prospective cohort study included adult trauma patients with severe injury (ISS[greater than or equal to]16). Data on in-hospital health care use, 24-month post-hospital health care use and productivity loss were obtained from hospital registry data and collected with the iMTA Medical Consumption and Productivity Cost Questionnaire. The questionnaires were completed 1 week and 1, 3, 6, 12 and 24 months after injury. Log-linked gamma generalized linear models were used to investigate the drivers of health care and productivity costs. In total, 174 severe injury patients were included in this study. The median age of participants was 55 years and the majority were male (66.1%). The mean hospital stay was 14.2 (SD = 13.5) days. Patients with paid employment returned to work 21 weeks after injury. In total, the mean costs per patient were [euro]24,760 with in-hospital costs of [euro]11,930, post-hospital costs of [euro]7,770 and productivity costs of [euro]8,800. Having an ISS [greater than or equal to]25 and lower health status were predictors of high health care costs and male sex was associated with higher productivity costs. Both health care and productivity costs increased with injury severity, although large differences were observed between patients. It is important for decision-makers to consider not only in-hospital health care utilization but also the long-term consequences and associated costs related to rehabilitation and productivity loss. Through improvements in trauma care there has been a decline in injury mortality, as more people survive severe trauma. Patients who survive severe trauma are at risk of long-term disabilities which may place a high economic burden on society. The purpose of this study was to estimate the health care and productivity costs of severe trauma patients up to 24 months after sustaining the injury. Furthermore, we investigated the impact of injury severity level on health care utilization and costs and determined predictors for health care and productivity costs.BACKGROUNDThrough improvements in trauma care there has been a decline in injury mortality, as more people survive severe trauma. Patients who survive severe trauma are at risk of long-term disabilities which may place a high economic burden on society. The purpose of this study was to estimate the health care and productivity costs of severe trauma patients up to 24 months after sustaining the injury. Furthermore, we investigated the impact of injury severity level on health care utilization and costs and determined predictors for health care and productivity costs.This prospective cohort study included adult trauma patients with severe injury (ISS≥16). Data on in-hospital health care use, 24-month post-hospital health care use and productivity loss were obtained from hospital registry data and collected with the iMTA Medical Consumption and Productivity Cost Questionnaire. The questionnaires were completed 1 week and 1, 3, 6, 12 and 24 months after injury. Log-linked gamma generalized linear models were used to investigate the drivers of health care and productivity costs.METHODSThis prospective cohort study included adult trauma patients with severe injury (ISS≥16). Data on in-hospital health care use, 24-month post-hospital health care use and productivity loss were obtained from hospital registry data and collected with the iMTA Medical Consumption and Productivity Cost Questionnaire. The questionnaires were completed 1 week and 1, 3, 6, 12 and 24 months after injury. Log-linked gamma generalized linear models were used to investigate the drivers of health care and productivity costs.In total, 174 severe injury patients were included in this study. The median age of participants was 55 years and the majority were male (66.1%). The mean hospital stay was 14.2 (SD = 13.5) days. Patients with paid employment returned to work 21 weeks after injury. In total, the mean costs per patient were €24,760 with in-hospital costs of €11,930, post-hospital costs of €7,770 and productivity costs of €8,800. Having an ISS ≥25 and lower health status were predictors of high health care costs and male sex was associated with higher productivity costs.RESULTSIn total, 174 severe injury patients were included in this study. The median age of participants was 55 years and the majority were male (66.1%). The mean hospital stay was 14.2 (SD = 13.5) days. Patients with paid employment returned to work 21 weeks after injury. In total, the mean costs per patient were €24,760 with in-hospital costs of €11,930, post-hospital costs of €7,770 and productivity costs of €8,800. Having an ISS ≥25 and lower health status were predictors of high health care costs and male sex was associated with higher productivity costs.Both health care and productivity costs increased with injury severity, although large differences were observed between patients. It is important for decision-makers to consider not only in-hospital health care utilization but also the long-term consequences and associated costs related to rehabilitation and productivity loss.CONCLUSIONSBoth health care and productivity costs increased with injury severity, although large differences were observed between patients. It is important for decision-makers to consider not only in-hospital health care utilization but also the long-term consequences and associated costs related to rehabilitation and productivity loss. |
| Audience | Academic |
| Author | de Jongh, Mariska A. C. Haagsma, Juanita A. Havermans, Roos J. M. de Munter, Leonie van der Vlegel, Marjolein Polinder, Suzanne |
| AuthorAffiliation | 2 Brabant Trauma Registry, Network Emergency Care Brabant, Tilburg, The Netherlands 3 Department Trauma TopCare, ETZ Hospital, Tilburg, The Netherlands 1 Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands University Hospital Zurich, SWITZERLAND |
| AuthorAffiliation_xml | – name: 2 Brabant Trauma Registry, Network Emergency Care Brabant, Tilburg, The Netherlands – name: 3 Department Trauma TopCare, ETZ Hospital, Tilburg, The Netherlands – name: University Hospital Zurich, SWITZERLAND – name: 1 Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands |
| Author_xml | – sequence: 1 givenname: Marjolein orcidid: 0000-0002-0217-9484 surname: van der Vlegel fullname: van der Vlegel, Marjolein – sequence: 2 givenname: Juanita A. surname: Haagsma fullname: Haagsma, Juanita A. – sequence: 3 givenname: Roos J. M. surname: Havermans fullname: Havermans, Roos J. M. – sequence: 4 givenname: Leonie surname: de Munter fullname: de Munter, Leonie – sequence: 5 givenname: Mariska A. C. surname: de Jongh fullname: de Jongh, Mariska A. C. – sequence: 6 givenname: Suzanne surname: Polinder fullname: Polinder, Suzanne |
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| Cites_doi | 10.1136/ip.2005.010983 10.1136/injuryprev-2016-042032 10.1093/eurpub/ckl006 10.1016/j.jval.2014.08.1791 10.1016/j.aap.2015.04.022 10.1016/j.injury.2006.07.009 10.1016/j.jval.2015.05.009 10.1097/SLA.0000000000001564 10.1097/TA.0b013e31802b71c9 10.1097/00005373-197403000-00001 10.2471/BLT.06.033803 10.1016/S0140-6736(14)61682-2 10.1136/injuryprev-2015-041616 10.1016/j.injury.2014.08.028 10.1186/1472-6963-12-267 10.1371/journal.pmed.1001140 10.1016/j.jss.2010.04.012 10.1097/01.ta.0000224124.47646.62 10.1016/j.injury.2013.02.025 10.1371/journal.pmed.1002322 10.1016/j.injury.2012.03.033 10.1089/tmj.2014.0021 10.1097/01.TA.0000112342.40296.1F 10.1371/journal.pone.0227131 10.1097/TA.0b013e3181ed4d29 10.1097/TA.0b013e3181a5cc34 10.1177/0269215507072084 10.1007/s00068-008-8013-0 10.1007/s11136-017-1521-9 10.2106/JBJS.K.00561 10.1002/hec.1124 10.1097/00005373-199905000-00003 10.1016/j.aap.2016.04.003 10.1097/01.TA.0000109758.75406.F8 |
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| Snippet | Background Through improvements in trauma care there has been a decline in injury mortality, as more people survive severe trauma. Patients who survive severe... Through improvements in trauma care there has been a decline in injury mortality, as more people survive severe trauma. Patients who survive severe trauma are... BackgroundThrough improvements in trauma care there has been a decline in injury mortality, as more people survive severe trauma. Patients who survive severe... |
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| SubjectTerms | Care and treatment Evaluation Medical care, Cost of Medicine and Health Sciences Wounds and injuries |
| Title | Long-term medical and productivity costs of severe trauma: Results from a prospective cohort study |
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