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  • Title: Effect of the elderly and increasing injury severity on acute hospital resource utilization in a cohort of inner city trauma patients.
    Author: Dinh MM, McNamara K, Bein KJ, Roncal S, Barnes EH, McBride K, Byrne CM.
    Journal: ANZ J Surg; 2013 Jan; 83(1-2):60-4. PubMed ID: 22882734.
    Abstract:
    OBJECTIVE: This study aimed to determine the relative effect of elderly patients and increasing injury severity on acute hospital costs and inpatient length of stay. METHODS: A prospective study of all trauma team activations at a single inner city trauma centre was conducted over a 1-year period. Costs were imputed using Australian Refined Diagnosis-Related Groups. Costs and inpatient length of stays were compared between elderly (age ≥65 years) and non-elderly patients. Relative effects of increasing injury severity score (ISS) and age categories were modelled using generalized linear regression. RESULTS: Over the study period, 1096 consecutive patients were studied. Falls were the most common mechanism and contributed the highest proportion of aggregate costs. There was a moderately high correlation between cost and ISS (Spearman's rank correlation coefficient 0.65, P < 0.001). Median costs for elderly patients were around three times higher than that for non-elderly patients and median length of stay was over twice that of non-elderly patients (7 days versus 3 days, P < 0.001). After adjusting for injury severity, the predicted costs of elderly trauma patients were around 30% higher compared with non-elderly patients. An increasing effect of injury severity on cost was observed across minor and major trauma. CONCLUSION: Both injury severity and elderly patients have a significant impact on acute hospital costs across the spectrum of major and minor trauma.
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