Hendrie D, Rosman D L, Harris A H
Road Accident Prevention Research Unit, University of Western Australia, Nedlands.
Aust J Public Health. 1994 Dec;18(4):380-8. doi: 10.1111/j.1753-6405.1994.tb00268.x.
The purpose of this study was to estimate the inpatient costs of road crashes in Western Australia, and to investigate factors relating to casualties and their injuries that affect the hospital costs resulting from road crashes. All road crash casualties who were injured severely enough to be hospitalised in Western Australia in 1988 were included. A casemix classification system was used to classify patients into diagnostic related groups. Hospital costs were assigned to individual patients on the basis of their diagnostic related group and length of hospital stay. The annual cost of hospital treatment for road crash casualties was estimated as $13.9 million, and 33 per cent of this was incurred by those with lower extremity injuries and 27 per cent by those with head injuries. Hospital costs per casualty ranged from an average of $1388 for those sustaining minor (Abbreviated Injury Scale severity score of 1 or 2) spinal injuries to $16,580 and $33,424, respectively, for those sustaining severe (Abbreviated Injury Scale severity score of 4 or 5) head and spinal injuries. A multivariate analysis of variance revealed the following factors as having a significant independent effect on the hospital inpatient costs of road crash casualties: type of hospital (teaching or nonteaching), body region of injury, injury severity level and road user group. There were also significant interaction effects between different factors. Since hospital inpatient costs vary considerably across factors, using average cost data in the specific economic evaluation of road safety interventions for groups of road users is inappropriate.
本研究旨在估算西澳大利亚道路交通事故的住院费用,并调查与伤亡人员及其损伤相关的、影响道路交通事故所致医院费用的因素。纳入了1988年在西澳大利亚因伤势严重而住院的所有道路交通事故伤亡人员。采用病例组合分类系统将患者分为诊断相关组。根据患者的诊断相关组和住院时间为其分配医院费用。道路交通事故伤亡人员的年度医院治疗费用估计为1390万美元,其中33%由下肢受伤者产生,27%由头部受伤者产生。每位伤亡人员的医院费用从轻度(简明损伤定级严重度评分为1或2)脊柱损伤者的平均1388美元到重度(简明损伤定级严重度评分为4或5)头部和脊柱损伤者的分别16580美元和33424美元不等。多变量方差分析显示以下因素对道路交通事故伤亡人员的医院住院费用有显著独立影响:医院类型(教学医院或非教学医院)、受伤身体部位、损伤严重程度级别和道路使用者群体。不同因素之间也存在显著的交互作用。由于医院住院费用因因素而异,在针对道路使用者群体的道路安全干预措施的具体经济评估中使用平均费用数据是不合适的。