Makkar Namrata, Gupta Amit, Modi Shrey, Bagaria Dinesh, Kumar Subodh, Chumber Sunil
Department of Hospital Administration, JPN Apex Trauma Centre, New Delhi, India.
Division of Trauma Surgery and Critical Care, JPN Apex Trauma Centre, New Delhi, India.
J Emerg Trauma Shock. 2019 Jan-Mar;12(1):23-29. doi: 10.4103/JETS.JETS_42_18.
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.
道路交通伤害(RTIs)的发生率正在上升,占国家国内生产总值的3%。对创伤系统进行成本分析以明智地分配资源至关重要。
研究在一级创伤中心就诊的患者的创伤护理经济负担,包括根据损伤情况对成本进行分层。
这是一项前瞻性研究,研究对象为该中心收治的多发伤患者(损伤严重度评分>16)。成本分析(成本描述性研究)通过自下而上的微观成本核算来计算医院的直接成本,其中考虑了固定成本和经常性成本,包括参考单位价格(RUPs)。根据损伤的解剖部位,还对主要损伤组(MIGs)的成本进行了分析。
包括受伤方式在内的人口统计学特征与其他研究相似。定义了代表大部分样本量的RUPs和MIGs。由于该政府机构服务的高度补贴性质,与其他国家相比,患者的费用较低。尽管如此,低收入群体的总支出仍高于当时的最低工资。创建合理的RUPs和对MIGs进行分组有助于通过针对性地实施战略成本降低措施来降低成本。
该研究表明微观成本核算是可行的。考虑到有创伤服务需求的低收入人群,需要进一步努力大幅降低成本。