An Analysis of the Economic Burden of the Trauma Services at a Level 1 Public Sector Trauma Center in South Asia.

Major injury groups microcosting reference unit price trauma

Journal

Journal of emergencies, trauma, and shock
ISSN: 0974-2700
Titre abrégé: J Emerg Trauma Shock
Pays: India
ID NLM: 101493921

Informations de publication

Date de publication:
Historique:
entrez: 7 5 2019
pubmed: 7 5 2019
medline: 7 5 2019
Statut: ppublish

Résumé

Incidence of road traffic injuries (RTIs) is increasing and accounting for country's 3% gross domestic product. It is crucial to perform a cost analysis of trauma systems to allocate resources judiciously. To study the economic burden of trauma care on the patient attending a level I trauma center including stratification of costs according to injury. This is a prospective study, with patients of polytrauma (Injury Severity Score >16) admitted in the center. Cost analysis (cost descriptive study) was done by calculating direct costs to hospital by bottom-up microcosting considering fixed and recurrent costs including reference unit prices (RUPs). According to the anatomical site of injuries, major injury groups (MIGs) costs were also analyzed. The demographics including mode of injury were similar to other studies. The RUP's and MIG's were defined which represented majority of the sample size. Due to highly subsidized nature of services in this Government institute, the cost to patient is less compared to other countries. Still, the total expenditure incurred by the low-income group was higher than the minimum wages at that time. The creation of plausible RUP's and the grouping of MIG's can help in reducing the costs by targeting and implementing strategic cost reduction measures. The study has shown that microcosting is feasible. Considering the low-income population demanding trauma services, further efforts are required to reduce costs substantially.

Sections du résumé

BACKGROUND BACKGROUND
Incidence of road traffic injuries (RTIs) is increasing and accounting for country's 3% gross domestic product. It is crucial to perform a cost analysis of trauma systems to allocate resources judiciously.
AIM AND OBJECTIVES OBJECTIVE
To study the economic burden of trauma care on the patient attending a level I trauma center including stratification of costs according to injury.
MATERIALS AND METHODS METHODS
This is a prospective study, with patients of polytrauma (Injury Severity Score >16) admitted in the center. Cost analysis (cost descriptive study) was done by calculating direct costs to hospital by bottom-up microcosting considering fixed and recurrent costs including reference unit prices (RUPs). According to the anatomical site of injuries, major injury groups (MIGs) costs were also analyzed.
RESULTS RESULTS
The demographics including mode of injury were similar to other studies. The RUP's and MIG's were defined which represented majority of the sample size. Due to highly subsidized nature of services in this Government institute, the cost to patient is less compared to other countries. Still, the total expenditure incurred by the low-income group was higher than the minimum wages at that time. The creation of plausible RUP's and the grouping of MIG's can help in reducing the costs by targeting and implementing strategic cost reduction measures.
CONCLUSION CONCLUSIONS
The study has shown that microcosting is feasible. Considering the low-income population demanding trauma services, further efforts are required to reduce costs substantially.

Identifiants

pubmed: 31057280
doi: 10.4103/JETS.JETS_42_18
pii: JETS-12-23
pmc: PMC6497000
doi:

Types de publication

Journal Article

Langues

eng

Pagination

23-29

Déclaration de conflit d'intérêts

There are no conflicts of interest.

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Auteurs

Namrata Makkar (N)

Department of Hospital Administration, JPN Apex Trauma Centre, New Delhi, India.

Amit Gupta (A)

Division of Trauma Surgery and Critical Care, JPN Apex Trauma Centre, New Delhi, India.

Shrey Modi (S)

Department of Surgical Disciplines, AIIMS, New Delhi, India.

Dinesh Bagaria (D)

Division of Trauma Surgery and Critical Care, JPN Apex Trauma Centre, New Delhi, India.

Subodh Kumar (S)

Division of Trauma Surgery and Critical Care, JPN Apex Trauma Centre, New Delhi, India.

Sunil Chumber (S)

Department of Surgical Disciplines, AIIMS, New Delhi, India.

Classifications MeSH