电动滑板车的财务影响：对一家城市一级创伤中心27个月内受伤情况的回顾（城市一级创伤中心电动滑板车受伤的成本）
Financial impact of electric scooters: a review of injuries over 27 months at an urban level 1 trauma center (cost of e-scooter injuries at an urban level 1 trauma center).
作者信息
Lavoie-Gagne Ophelie, Siow Matthew, Harkin William E, Flores Alec R, Politzer Carey S, Mitchell Brendon C, Girard Paul J, Schwartz Alexandra K, Kent William T
机构信息
Department of Orthopaedic Surgery, University of California San Diego, La Jolla, California, USA.
出版信息
Trauma Surg Acute Care Open. 2021 Jan 22;6(1):e000634. doi: 10.1136/tsaco-2020-000634. eCollection 2021.
BACKGROUND
Electric scooters (e-scooters) have become a widespread method of transportation due to convenience and affordability. However, the financial impact of medical care for sustained injuries is currently unknown. The purpose of this study is to characterize total billing charges associated with medical care of e-scooter injuries.
METHODS
A retrospective review of patients with e-scooter injuries presenting to the trauma bay, emergency department or outpatient clinics at an urban level 1 trauma center was conducted from November 2017 to March 2020. Demographic and clinical data were collected. Primary outcomes of interest were total billing charges and billing to insurance (hospital and professional). Multivariable models were used to identify preventable risk factors associated with higher total billing charges.
RESULTS
A total of 63 patients were identified consisting of 42 (66.7%) males, average age 40.19 (SD 13.29) years and 3.2% rate of helmet use. Patients sustained orthopedic (29%, n=18), facial (48%, n=30) and cranial (23%, n=15) injuries. The average total billing charges for e-scooter clinical encounters was $95 710 (SD $138 215). Average billing to insurance was $86 376 (SD $125 438) for hospital charges and $9 334 (SD $14 711) for professional charges. There were no significant differences in charges between injury categories. On multivariable regression, modifiable risk factors independently associated with higher total billing charges included any intoxication prior to injury ($231 377 increase, p=0.02), intracranial bleeds ($75 528, p=0.04) and TBI ($360 898, p=0.006).
DISCUSSION
Many patients sustain high-energy injuries during e-scooter accidents with significant medical and financial consequences. Further studies may continue expanding the financial impact of e-scooter injuries on both patients and the healthcare system.
LEVEL OF EVIDENCE
III.
背景
电动滑板车因其便利性和经济性已成为一种广泛使用的交通方式。然而，目前尚不清楚持续受伤的医疗护理的经济影响。本研究的目的是描述与电动滑板车受伤医疗护理相关的总计费费用。
方法
对2017年11月至2020年3月期间在城市一级创伤中心的创伤病房、急诊科或门诊就诊的电动滑板车受伤患者进行回顾性研究。收集人口统计学和临床数据。主要关注的结果是总计费费用和向保险公司的计费（医院和专业费用）。使用多变量模型来识别与较高总计费费用相关的可预防风险因素。
结果
共确定了63例患者，其中男性42例（66.7%），平均年龄40.19岁（标准差13.29），头盔使用率为3.2%。患者遭受骨科损伤（29%，n = 18）、面部损伤（48%，n = 30）和颅脑损伤（23%，n = 15）。电动滑板车临床诊疗的平均总计费费用为95710美元（标准差138215美元）。医院费用向保险公司的平均计费为86376美元（标准差125438美元），专业费用为9334美元（标准差14711美元）。不同损伤类别之间的费用没有显著差异。在多变量回归中，与较高总计费费用独立相关的可改变风险因素包括受伤前任何中毒情况（增加231377美元，p = 0.02）、颅内出血（75528美元，p = 0.04）和创伤性脑损伤（360898美元，p = 0.006）。
讨论
许多患者在电动滑板车事故中遭受高能损伤，会产生重大的医疗和经济后果。进一步的研究可能会继续扩大电动滑板车受伤对患者和医疗系统的经济影响。
证据级别
三级。
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