Estimating annual medical and out-of-pocket expenditures associated with traumatic injuries in the United States

Alghnam, Suliman; Vanness, David J.; Gaskin, Darrell J.; Thorpe, Roland J.; Castillo, Renan C.

doi:10.1097/ta.0000000000000910

Cited by 13 publications

(17 citation statements)

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“…Because the MEPS is a weighted sample and to account for the survey weights, strata and clustering of individuals, the survey command was used to provide nationally representative results of US non-institutionalised populations. Following AHRQ's recommendation, we divided survey weights by 2 to provide annual estimates of the injured and non-injured US populations 17. Descriptive characteristics by injury status were obtained.…”

Section: Methodsmentioning

confidence: 99%

Traumatic injuries and persistent opioid use in the USA: findings from a nationally representative survey

Alghnam

Castillo

2016

Inj Prev

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BackgroundAlthough opioid abuse is a rising epidemic in the USA, there are no studies to date on the incidence of persistent opioid use following injuries. Therefore, the aims of this study are: (1) to examine the incidence of persistent opioid use among a nationally representative sample of injured and non-injured populations; (2) to evaluate whether an injury is an independent predictor of persistent opioid use.MethodData from the Medical Expenditure Panel Survey were pooled (years 2009–2012). Adults were followed for about 2 years, during which they were surveyed about injury status and opioid use every 4–5 months. To determine whether injuries are associated with persistent opioid use, weighted multiple logistic regressions were constructed.ResultsWhile 2.3 million injured individuals received any opioid during the follow-up, 371 170 (15.6%) individuals became persistent opioid users (defined as opioid use across multiple time points). In a multiple logistic regression analysis adjusting for sociodemographic characteristics and self-reported health, those who sustained injuries were 1.4 times (95% CI 1.1 to 1.9) more likely to report persistent opioid use than those without injuries.ConclusionsWe found injuries to be significantly associated with persistent opioid use in a nationally representative sample. Further investment in injury prevention may facilitate reduction of persistent opioid use and, thus, improve population health and reduce health expenditures.

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Section: Methodsmentioning

confidence: 99%

Traumatic injuries and persistent opioid use in the USA: findings from a nationally representative survey

Alghnam

Castillo

2016

Inj Prev

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“…Trauma is the leading cause of death worldwide and in the United States in those aged 1 to 44 years old . Hemorrhage is the leading cause of potentially preventable death.…”

Section: Discussionmentioning

confidence: 99%

“…The economic burden is tremendous, with it ranking first in the number of productive life years lost, but the actual cost of care has been sparsely investigated. Expenditures are estimated between $168 and $400 billion per year, including $38 to $80 billion in direct costs . Although massively bleeding patients represent a small percentage of overall trauma patients, they are the most resource intensive to care for and have substantially more direct cost attributable to them …”

Section: Discussionmentioning

confidence: 99%

“…It is estimated to be the sixth most costly health care condition in the United States resulting in between $168 billion to over $400 billion dollars in total yearly costs including $38 billion to $80 billion in direct costs. The vast majority of the total variation in expenditures reflects the difficulty in quantifying indirect expenditures including costs associated with loss of life expectancy …”

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confidence: 99%

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Cost‐effectiveness evaluation of the PROPPR trial transfusion protocols

et al. 2020

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BACKGROUND There have been no prior investigations of the cost effectiveness of transfusion strategies for trauma resuscitation. The Pragmatic, Randomized, Optimal Platelet and Plasma Ratios (PROPPR) study was a Phase III multisite, randomized trial in 680 subjects comparing the efficacy of 1:1:1 transfusion ratios of plasma and platelets to red blood cells with the 1:1:2 ratio. We hypothesized that 1:1:1 transfusion results in an acceptable incremental cost‐effectiveness ratio, when estimated using patientsʼ age‐specific life expectancy and cost of care during the 30‐day PROPPR trial period. STUDY DESIGN AND METHODS International Classification of Diseases, Ninth Revision codes were prospectively collected, and subjects were matched 1:2 to subjects in the Healthcare Utilization Program State Inpatient Data to estimate cost weights. We used a decision tree analysis, combined with standard costs and estimated years of expected survival to determine the cost effectiveness of the two treatments. RESULTS The 1:1:1 group had higher overall costs for the blood products but were more likely to achieve hemostasis and decreased hemorrhagic death by 24 hours (p = 0.006). For every 100 patients treated in the 1:1:1 group, eight more achieved hemostasis than in the 1:1:2 group. At 30 days, the total hospital cost per 100 patients was $5.6 million in the 1:1:1 group compared with $5.0 million in the 1:1:2 group. For each 100 patients, the 1:1:1 group had 218.5 more years of life expectancy. This was at a cost of $2994 per year gained. CONCLUSION The 1:1:1 transfusion ratio in severely injured hemorrhaging trauma patients is a very cost‐effective strategy for increasing hemostasis and decreasing trauma deaths.

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“…Not only in China, but also the expenditure on injury treatment was high in some developed countries. The adjusted national medical cost of injuries was estimated at 56 billion dollars and out-ofpocket cost was approximately 4 billion dollars in the USA [24].…”

Section: Differences In Cce Consumption In Different Age Groups Withmentioning

confidence: 99%

The Burden of the Current Curative Expenditure of Injury in Dalian, China-A study Based on "System of Health Accounts 2011"

Sun

Hu³

et al. 2020

Preprint

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Background: Injury is one of the major public health problems, which causes more than 5 million deaths in the world every year. Cases of specific types of injury put a tremendous threat to human health and also add a heavy medical burden on individuals and societies. This study was to calculate and analyze the current curative expenditure (CCE) of injury in Dalian and consequently to provide control strategies for decision-makers.Methodology: A total of 565 medical institutions were selected with multistage stratified cluster random sampling, containing 4,375,351 valid samples. Subsequently, the distribution of injury CCE in different dimensions (including age and site of injury) was analyzed under the framework of System of Health Accounts 2011(SHA 2011) using the established database.Results: There were increases from 32.36/100,000 in 2006 to 37.34/100,000 in 2017 and from 46.12/100,000 in 2006 to 54.48/100,000 in 2017 in urban and rural residents respectively. The study found that the CCE of injury in Dalian had reached 1572.73 million RMB, accounting for 7.45% of the total curative care expenditure. In the 15-25 age group, the cost of injury accounts for a larger proportion of CCE than other age groups. Among the injuries in different regions of the body, injuries to the spine, lower limb, head and foreign body entering cost the most.Conclusions: Dalian has a relatively serious burden of injury costs. The essential and primary goal is to reduce the cost and increase the benefit of attending to patients with injuries. Specific control strategies should be tilted toward the age group 15-25. Injuries to the spine, lower limb, head and foreign body entering also should be priorities of interventions.

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Estimating annual medical and out-of-pocket expenditures associated with traumatic injuries in the United States

Abstract: Economic and evaluation study, level III.

Cited by 13 publications

References 30 publications

Traumatic injuries and persistent opioid use in the USA: findings from a nationally representative survey

Traumatic injuries and persistent opioid use in the USA: findings from a nationally representative survey

Cost‐effectiveness evaluation of the PROPPR trial transfusion protocols

The Burden of the Current Curative Expenditure of Injury in Dalian, China-A study Based on "System of Health Accounts 2011"

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