THE EFFECT OF REGIONAL TRAUMA CARE SYSTEMS ON COSTS

Objective: To assess cost savings from regional trauma care systems. D esign: Multivariate regression analysis is used to isolate the effects of regional trauma care systems on medical costs while controlling fo r personal and injury characteristics and other factors likely to infl uence medical costs. Percentage reductions in costs are translated int o dollar cost savings with corrections for excluded costs and losses f rom premature death. Setting: Injuries to workers filing workers' comp ensation lost workday claims.Participants: Randomly sampled workers' c ompensation claims from 17 states filed between 1979 and 1988 (N=217 0 00). Main Outcome Measure: Medical payments per episode of four injury groups: lower-extremity fractures and dislocations, upper-extremity f ractures and dislocations, other upper-extremity injuries, and back st rains and sprains. We distinguish hospitalized from nonhospitalized cl aims. Results: Statistical analyses reveal that states with trauma car e systems have 15.5% lower costs per hospitalized injury episode. Savi ngs average $1025 per case in 1988 dollars. Costs per episode for disa bling nonhospitalized injury are 10% lower in states with trauma care systems, with savings averaging $75 per case. The largest savings are for back injuries. Conclusions: Extending trauma care systems nationwi de could lower annual medical care payments by $3.2 billion. Including productivity losses due to premature death, the savings could total $ 10.3 billion, 5.9% of national injury costs.