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February 1995

The Effect of Regional Trauma Care Systems on Costs

Author Affiliations

From the Safety and Health Policy Program, National Public Services Research Institute, Landover, Md (Dr Miller); and the Department of Economics, University of Baltimore (Md) (Dr Levy).

Arch Surg. 1995;130(2):188-193. doi:10.1001/archsurg.1995.01430020078014

Objective:  To assess cost savings from regional trauma care systems.

Design:  Multivariate regression analysis is used to isolate the effects of regional trauma care systems on medical costs while controlling for personal and injury characteristics and other factors likely to influence medical costs. Percentage reductions in costs are translated into dollar cost savings with corrections for excluded costs and losses from premature death.

Setting:  Injuries to workers filing workers' compensation lost workday claims.

Participants:  Randomly sampled workers' compensation claims from 17 states filed between 1979 and 1988 (N=217 000).

Main Outcome Measure:  Medical payments per episode of four injury groups: lower-extremity fractures and dislocations, upper-extremity fractures and dislocations, other upper-extremity injuries, and back strains and sprains. We distinguish hospitalized from nonhospitalized claims.

Results:  Statistical analyses reveal that states with trauma care systems have 15.5% lower costs per hospitalized injury episode. Savings average $1025 per case in 1988 dollars. Costs per episode for disabling nonhospitalized injury are 10% lower in states with trauma care systems, with savings averaging $75 per case. The largest savings are for back injuries.

Conclusions:  Extending trauma care systems nationwide could lower annual medical care payments by $3.2 billion. Including productivity losses due to premature death, the savings could total $10.3 billion, 5.9% of national injury costs.(Arch Surg. 1995;130:188-193)

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