Health care costs of injury in the older population: a prospective multicentre cohort study in the Netherlands

BMC Geriatrics

Leonie de Munter¹  Mariska A. C. de Jongh¹  Marjolein van der Vlegel²  A. J. L. M. Geraerds²  Suzanne Polinder²  Juanita A. Haagsma² 

[1] Department Trauma TopCare, ETZ Hospital, Tilburg, The Netherlands;Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands;

关键词: Health care costs;    Wounds and injuries;    Aged;    Critical care;    Generalized linear model;   

DOI  :  10.1186/s12877-020-01825-z

来源: Springer

【 摘 要 】

BackgroundWith the ageing population, the number of older trauma patients has increased. The aim of this study was to assess non-surgical health care costs of older trauma patients and to identify which characteristics of older trauma patients were associated with high health care costs.MethodsTrauma patients aged ≥65 years who were admitted to a hospital in Noord-Brabant, the Netherlands, were included in the Brabant Injury Outcome Surveillance (BIOS) study. Non-surgical in-hospital and up to 24- months post-hospital health care use were obtained from hospital registration data and collected with the iMTA Medical Consumption Questionnaire which patients completed 1 week and 1, 3, 6, 12 and 24 months after injury. Log-linked gamma generalized linear models were used to identify cost-driving factors.ResultsA total of 1910 patients were included in the study. Mean total health care costs per patient were €12,190 ranging from €8390 for 65–69 year-olds to €15,550 for those older than 90 years. Main cost drivers were the post-hospital costs due to home care and stay at an institution. Falls (72%) and traffic injury (15%) contributed most to the total health care costs, although costs of cause of trauma varied with age and sex. In-hospital costs were especially high in patients with high injury severity, frailty and comorbidities. Age, female sex, injury severity, frailty, having comorbidities and having a hip fracture were independently associated with higher post-hospital health care costs.ConclusionsIn-hospital health care costs were chiefly associated with high injury severity. Several patient and injury characteristics including age, high injury severity, frailty and comorbidity were associated with post-hospital health care costs. Both fall-related injuries and traffic-related injuries are important areas for prevention of injury in the older population.

【 授权许可】

CC BY