ANALYSIS OF COSTS IN THE CLINICAL TREATME NT OF SEVERELY INJURED PATIENTS

In order to assess the costs arising from the treatment of polytraumat ized patients we analysed the data of 100 prospectively studied multip le trauma patients (ISS 38) calculating all medical expenses during th eir clinical stay. The average cost per patient in the studied group ( n = 100) amounted to 63989.- DM. About 65 % of this sum derived from t he costs of intensive care, while the expenses for operations covered 19 %. The group of primarily deceased patients (n = 25) generated the lowest costs of 8468.- DM (per pat.). The highest costs of 95626.- DM were caused by the treatment of patients (n = 32) that developed one o r more complications (organ failure) during their stay in the intensiv e care unit or died (n = 10) during this therapy (101940.-DM). Since t he data concerning medical equipment (i.e. surgical devices, radiologi cal equipment) were not centrally registered in the administration dep artment of our clinic, it was not possible to include these costs into this calculation. Thus the total costs must be presumed higher. A rel ationship between costs of treatment and injury severity (ISS) appeare d in polytrauma only by a cost reduction in early deceased very severe ly injured patients (ISS > 70). The primary diagnosis (injury pattern and severity) cannot predict the incidence of complications increasing the costs of treatment. In the presented study we did not find a corr elation between age and treatment costs. It is necessary to consider t he high costs of the initial treatment of polytraumatized patients whi le establishing therapy flat rates in order to secure the actual high standard of medical care as well as to avoid financial losses for trau ma centers. Thus an increase of consecutive costs (medical, rehabilita tive, socioeconomic) deriving from insufficient primary care can be pr evented.