Article

Factors affecting hospital charges and length of stay from teenage motor vehicle crash-related hospitalizations among United States teenagers, 2002-2007

University of Iowa Injury Prevention Research Center, United States.
Accident; analysis and prevention (Impact Factor: 1.65). 05/2011; 43(3):595-600. DOI: 10.1016/j.aap.2010.07.019
Source: PubMed

ABSTRACT Motor vehicle crashes are the leading cause of death for all teenagers, and each year a far greater number of teens are hospitalized with non-fatal injuries. This retrospective cohort study used the National Inpatient Sample data to examine hospitalizations from the years 2002 to 2007 for 15-18-year-old teenagers who had been admitted due to a motor vehicle crash. More than 23,000 teens were hospitalized for motor vehicle-related crash injuries each year, for a total of 139,880 over the 6-year period. Total hospital charges exceeded $1 billion almost every year, with a median hospital charge of more than $25,000. Older teens, boys, those with fractures, internal injuries or intracranial injuries, and Medicaid/Medicare as a payer were associated with higher hospital charges and longer lengths of stay. These high charges and hospitalization periods pose a significant burden on teens, their families, and the health care system.

0 Followers
 · 
194 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Object The purpose of this study was to evaluate temporal trends in traumatic brain injury (TBI); the impact of hospital volume and surgeon volume on length of stay (LOS), hospitalization cost, and in-hospital mortality rate; and to explore predictors of these outcomes in a nationwide population in Taiwan. Methods This population-based patient cohort study retrospectively analyzed 16,956 patients who had received surgical treatment for TBI between 1998 and 2009. Bootstrap estimation was used to derive 95% confidence intervals for differences in effect sizes. Hierarchical linear regression models were used to predict outcomes. Results Patients treated in very-high-volume hospitals were more responsive than those treated in low-volume hospitals in terms of LOS (-0.11; 95% CI -0.20 to -0.03) and hospitalization cost (-0.28; 95% CI -0.49 to -0.06). Patients treated by high-volume surgeons were also more responsive than those treated by low-volume surgeons in terms of LOS (-0.19; 95% CI -0.37 to -0.01) and hospitalization cost (-0.43; 95% CI -0.81 to -0.05). The mean LOS was 24.3 days and the average LOS for very-high-volume hospitals and surgeons was 61% and 64% shorter, respectively, than that for low-volume hospitals and surgeons. The mean hospitalization cost was US $7,292.10, and the average hospitalization cost for very-high-volume hospitals and surgeons was 19% and 22% lower, respectively, than that for low-volume hospitals and surgeons. Advanced age, male sex, high Charlson Comorbidity Index score, treatment in a low-volume hospital, and treatment by a low-volume surgeon were significantly associated with adverse outcomes (p < 0.001). Conclusions The data suggest that annual surgical volume is the key factor in surgical outcomes in patients with TBI. The results improve the understanding of medical resource allocation for this surgical procedure, and can help to formulate public health policies for optimizing hospital resource utilization for related diseases.
    Journal of Neurosurgery 01/2013; 118(4). DOI:10.3171/2012.12.JNS12693 · 3.15 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective This study describes the medical and financial impact (hospital charges) of aggressive driving-related injuries in Ohio. Methods Statewide crash and hospital databases were probabilistically linked for 2004 through 2009. Descriptive analyses and multivariate regression modeling of multiply-imputed data on motor vehicle occupants involved in aggressive driving-related crashes were performed. Results There were 821,136 motor vehicle occupants involved in aggressive driving-related crashes in Ohio from 2004 through 2009; injuries were sustained by 15.0%. The rate of aggressive driving-related crashes was highest among drivers ages 16 to 19 years (3787.1 crashes per 100,000 licensed drivers). Aggressive driving-related inpatients accrued more than $250.8 million in hospital charges and 28,366 inpatient days of treatment in 2004 through 2009. Occupants ages 16 to 19 years had higher odds of sustaining injury when involved in aggressive driving-related crashes (OR = 1.10; 95% CI = 1.07, 1.12; p < 0.001), but lower odds of death, inpatient admission, ISS ≥ 16, and rehabilitation. Discussion Aggressive driving-related injuries have a substantial medical and financial impact in Ohio. Practical Applications Compared with other highway safety issues, prevention efforts aimed specifically at aggressive driving are lacking. Targeted enforcement and public awareness campaigns are needed.
    Journal of Safety Research 12/2014; DOI:10.1016/j.jsr.2014.08.003 · 1.29 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Intervention or evaluation studies represent a small proportion of traffic psychology research. The current study evaluated the effectiveness of a road safety intervention by measuring attitudes toward unsafe driving behaviors and risk perception. A sample of high school students (n=133) participated in a road safety intervention program focusing on attitudes and risk perceptions of young people as novice drivers, pre-drivers, and passengers. This sample was compared with a matched sample of students who did not take the program (n=172) on their attitudes and perceived risk toward unsafe driving, both prior to the program (T1), immediately after the program (T2), and at 6-week follow-up (T3). While no changes in attitudes toward unsafe driving were found for the control group, the intervention group reported riskier attitudes toward unsafe driving behaviors from T1 to T2 and T3. No differences were found from T1 to T3 in perceived risk toward unsafe driving for either the intervention or control groups. Implications of the study include encouraging a higher rate of road safety program evaluations, leading to better understanding of the effectiveness of road safety intervention programs and how they may be designed and delivered to ensure lower engagement in unsafe driving behaviors by young drivers.
    Accident; analysis and prevention 12/2013; 64C:100-110. DOI:10.1016/j.aap.2013.11.017 · 1.65 Impact Factor