HOSPITAL CHARGES TO INJURED DRINKING DRIVERS IN WASHINGTON-STATE - 1989-1993

The Washington State Patrol Crash Database and computerized hospitaliz ation records for 1989-1993 were used to determine total hospital char ges billed for motor vehicle collision injuries to drivers whose crash reports contained any indication of alcohol use. In this population-b ased study, total hospital charges were summed, and mean charges and l engths of stay were computed within alcohol use and insurance coverage status categories in an attempt to evaluate the hospital charges bill ed to public funding and private insurance. Of the total hospital char ges for drivers with injuries from motor vehicle collisions for which a police-reported indicator of alcohol use status was available, 43% ( U.S.$64.8 million) were for drivers who reportedly had been drinking. At the time of discharge, Medicaid was identified as the payor for 47% of these hospitalizations. The mean hospital charge billed per collis ion was greater for drinking (U.S.$18,258) than nondrinking drivers (U .S.$14,181). Drinking drivers also had longer hospital stays, even aft er adjustment for patient age, gender and injury severity. During this time in Washington state, the average annual amount billed at dischar ge for initial inpatient care of injuries to drivers who reportedly ha d been drinking at the time of the motor vehicle collision was U.S.$13 million. This includes only the amount assessed by the hospital at th e time of discharge for treatment of the initial injury and does not i nclude other related medical charges for rehabilitation or outpatient care, or for doctors' or laboratory fees. As increasing pressures of m anaged and capitated care lead to a shift of financial risk from the f ederal government and insurers to states and providers, the financial burden of specific, potentially preventable conditions such as this wi ll receive greater attention. (C) 1998 Elsevier Science Ltd. All right s reserved.