ANALYSIS OF COSTS FOR EMERGENCY CARE AND ICU TREATMENT IN MULTIPLE TRAUMA

Treatment costs of emergency therapy, surgery and intensive care were analysed in 20 randomly chosen, representative patients with severe mu ltiple trauma (mean ISS 32 p). For an average stay of about 22.5 days in the ICU, the total costs were DM 106,924.36 (about 70,000 US $), wh ich breaks down as DM 39,635.88 (=37%) for physicians and nurses, DM 6 7,289.08 (=63%) for materials, X-rays, laboratory investigations, drug s and blood components. The whole treatment caused daily costs of DM 4 .752.22, or DM 3.30 per min. The first emergency diagnostic procedures and emergency therapy take a mean of 451.9 min from admission to the beginning of the ICU treatment and itself generates costs of about DM 12,325.99. In Germany a new system of compensation by diagnosis-relate d group was introduced in 1996. Therefore, these data indicate that tr eatment of severe multiple trauma is very expensive and trauma care co uld be economically by damaging for smaller hospitals. We conclude tha t treatment of multiply injured patients (ISS > 16 p) should be concen trated in selected trauma centres and compensated by payment of a spec ial daily amount of about DM 5,000 (about 3,500 US $).