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

被引:14
作者
van der Vlegel, Marjolein [1 ]
Haagsma, Juanita A. [1 ]
Geraerds, A. J. L. M. [1 ]
de Munter, Leonie [2 ]
de Jongh, Mariska A. C. [2 ]
Polinder, Suzanne [1 ]
机构
[1] Univ Med Ctr Rotterdam, Dept Publ Hlth, Erasmus MC, Rotterdam, Netherlands
[2] ETZ Hosp, Dept Trauma TopCare, Tilburg, Netherlands
关键词
Health care costs; Wounds and injuries; Aged; Critical care; Generalized linear model; HIP FRACTURE; FRAILTY; TRAUMA; ADULTS; FALLS; PREVALENCE; PREDICTORS; MORTALITY; ELDERS; AGE;
D O I
10.1186/s12877-020-01825-z
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Background With 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. Methods Trauma 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. Results A total of 1910 patients were included in the study. Mean total health care costs per patient were euro12,190 ranging from euro8390 for 65-69 year-olds to euro15,550 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. Conclusions In-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.
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页数:11
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