Malek M, Chang B H, Gallagher S S, Guyer B
Injury Control Center, Harvard School of Public Health, Boston, Massachusetts 02115.
Ann Emerg Med. 1991 Sep;20(9):997-1005. doi: 10.1016/s0196-0644(05)82979-8.
To estimate the mean cost of initial medical treatment for a variety of injury types and injury causes and project the national cost of initial medical care for injuries to children.
We combined injury incidence data from the Massachusetts Statewide Childhood Injury Prevention Project (SCIPP) with a claims data set (1987 charges) from the Health Data Institute, Lexington, Massachusetts.
SCIPP incidence data were obtained from hospital emergency department and inpatient facilities for a population of 87,000 Massachusetts children 0 to 19 years old between 1979 and 1982. Health Data Institute charge data for children were derived from insurance claims for 3% of all privately insured patients throughout the United States.
The estimated mean cost of initial hospitalization for injury was $5,094, while ED care was $171. Projected annual cost for initial medical care of injury to children for the nation was $5.1 billion, which was about equally divided between cases seen in EDs and those requiring inpatient care. Although there was little difference in mean cost between the genders, mean cost increased with age. Because of both a higher injury incidence and a greater mean cost per injury, the projected initial cost of injuries to teenagers 15 to 19 years old was much higher than that of younger children.
Expenditures for medical care of injured children, particularly adolescents, are great. The prevention of childhood injuries should become a higher priority in the United States. To improve the quality of national estimates of the incidence and cost of injury, a national surveillance system for nonfatal injuries should be developed. Such a system should include information on the major causes of injury and their costs.
估计各类损伤类型和损伤原因的初始医疗治疗平均费用,并预测全国儿童损伤初始医疗护理费用。
我们将马萨诸塞州全州儿童伤害预防项目(SCIPP)的伤害发生率数据与马萨诸塞州列克星敦健康数据研究所的索赔数据集(1987年费用)相结合。
SCIPP发生率数据来自医院急诊科和住院设施,涉及1979年至1982年间马萨诸塞州87,000名0至19岁儿童。健康数据研究所儿童收费数据来自美国所有私人保险患者中3%的保险索赔。
损伤初始住院治疗的估计平均费用为5,094美元,而急诊护理费用为171美元。全国儿童损伤初始医疗护理的预计年度费用为51亿美元,其中急诊科就诊病例和需要住院护理的病例费用大致相当。虽然两性之间的平均费用差异不大,但平均费用随年龄增长而增加。由于15至19岁青少年的损伤发生率较高且每次损伤的平均费用更高,因此该年龄段青少年损伤的预计初始费用远高于年幼儿童。
受伤儿童,尤其是青少年的医疗护理费用很高。在美国,预防儿童伤害应成为更高的优先事项。为提高全国对损伤发生率和费用估计的质量,应建立一个非致命损伤国家监测系统。这样的系统应包括有关损伤主要原因及其费用的信息。