An Analysis of the Economic Burden of the Trauma Services at a Level 1 Public Sector Trauma Center in South Asia

• Published in: Journal of emergencies, trauma and shock trauma and shock, 2019-01, Vol.12 (1), p.23-29
• Main Authors: Makkar, Namrata, Gupta, Amit, Modi, Shrey, Bagaria, Dinesh, Kumar, Subodh, Chumber, Sunil
• Format: Article
• Language: English
• Subjects: Accounting; Air conditioning; Analysis; Bias; Care and treatment; Caregivers; Cost analysis; Crash injuries; Economic aspects; Emergency medical services; Expenditures; Fatalities; Finance; Fixed assets; GDP; Gross Domestic Product; Health aspects; Health care costs; Health insurance; Hospitals; Land area; Major injury groups; Medical research; microcosting; Original; Patients; Public health; Public sector; reference unit price; Resource allocation; Traffic accidents; Trauma; Trauma care; Trauma centers; Wages & salaries
• ISSN: 0974-2700; 0974-519X
• DOI: 10.4103/JETS.JETS_42_18

Background: 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. Aim and Objectives: To study the economic burden of trauma care on the patient attending a level I trauma center including stratification of costs according to injury. Materials and Methods: 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. Results: 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. Conclusion: The study has shown that microcosting is feasible. Considering the low-income population demanding trauma services, further efforts are required to reduce costs substantially.