Phillips D E, Langley J D, Marshall S W
Otago Area Health Board, Dunedin.
N Z Med J. 1993 Jun 9;106(957):215-7.
To describe the cost of inpatient admissions and emergency department attendances for injury at a major New Zealand hospital; and to extrapolate to indicative national costs for injury, with a view to facilitating decision making, in relation to injury prevention programs.
By using data from the patient management system database and the resource utilisation system operating at Dunedin Hospital to describe the utilisation spectrum for injury related events.
The institutional cost of inpatient care for injury cases for the year ending 31 December 1990 amounted to $7,378,000, at an average of $3,020 a case. The costs for emergency department attendances (not resulting in admission) amounted to $2,585,000, at an average of $93 a case; the total of $9,963,000 equated to 15% of the hospitals annual operating budget. The most expensive causes of admission with injury were falls and motor vehicle traffic crashes. The commonest resulting injury was fractures of the lower limb, and the commonest and cumulatively most expensive injuries presenting at the emergency department were cuts, and sprains and strains. If these costs were extrapolated to New Zealand as a whole it would suggest hospital costs of approximately $457 million per annum; when taken in conjunction with other known medical and welfare costs this approximates to an annual bill to the state of approximately $1.2 billion per annum.
Injuries are a significant, costly, potentially preventable, element of health care. The use of hospital data for the allocation of resources to preventive efforts to date, has been based primarily on hospital admission numbers. This study suggests that this is not however indicative of the costs to the state, and the use of financial and other utilisation data would assist in rationalising resource allocation to preventive programs.
描述新西兰一家大型医院因伤住院和急诊就诊的费用；并推断出全国因伤的指示性费用，以便为伤害预防计划的决策提供便利。
利用达尼丁医院患者管理系统数据库和资源利用系统的数据，描述与伤害相关事件的利用情况。
截至1990年12月31日的年度，伤害病例的住院护理机构成本达737.8万美元，平均每例3020美元。急诊就诊（未导致住院）的费用为258.5万美元，平均每例93美元；总计996.3万美元相当于医院年度运营预算的15%。因伤住院最昂贵的原因是跌倒和机动车交通事故。最常见的受伤结果是下肢骨折，在急诊科最常见且累计费用最高的受伤类型是割伤、扭伤和拉伤。如果将这些费用推算至整个新西兰，这表明每年医院费用约为4.57亿美元；与其他已知的医疗和福利费用相结合，这大致相当于国家每年约12亿美元的账单。
伤害是医疗保健中一个重大、昂贵且可能预防的因素。迄今为止，利用医院数据为预防工作分配资源主要基于医院入院人数。然而，本研究表明，这并不能表明国家的成本，使用财务和其他利用数据将有助于合理分配预防计划的资源。
