[Cost analysis of primary care and intensive care treatment of multiple trauma patients]

Abstract

Treatment costs of emergency therapy, surgery and intensive care were analysed in 20 randomly chosen, representative patients with severe multiple trauma (mean ISS 32 p). For an average stay of about 22.5 days in the ICU, the total costs were DM 106,924.36 (about $70,000), which breaks down as DM 39,635.88 (= 37%) for physicians and nurses, DM 67,289.08 (= 63%) for materials, X-rays, laboratory investigations, drugs and blood components. The whole treatment caused daily costs of DM 4,752.22, or DM 3.30 per min. The first emergency diagnostic procedures and emergency therapy take a mean of 451.9 min from admission to the beginning of the ICU treatment and itself generates costs of about DM 12,325.99. In Germany a new system of compensation by diagnosis-related group was introduced in 1996. Therefore, these data indicate that treatment of severe multiple trauma is very expensive and trauma care could be economically by damaging for smaller hospitals. We conclude that treatment of multiply injured patients (ISS > 16 p) should be concentrated in selected trauma centres and compensated by payment of a special daily amount of about DM 5,000 (about $3,500).