Traffic collisions, Related Groups by Diagnosis and Hospital Costs Clinical characteristics and costs for 740 patients hospitalized for traffic collisions in the 2012-2014 three year period at the Asistencial Medica Departamental of Maldonado, Uruguay
Abstract
Introduction: every year, almost 1.3 million people in the world die as a result of traffic collisions, and these accidents represent 1% to 3% of the Gross Domestic Product (GDP) of each country.
Mortality for traffic collisions in Uruguay was 16 out of 100,000 people in 2012, 2013 and 2014; whereas in the Department of Maldonado it was 24.3 fatalities every 100,000 people during the same period.
Objective: to contribute to Pillar 5 of the Global Plan developed by the United Nations Road Safety Collaboration, providing clinical data and costs of hospitalized patients who were part of a traffic collision.
Method: descriptive, retrospective study that analyses hospitalization activity in La Asistencial Médica Departamental de Maldonado (AMDM) (a private healthcare institution in Maldonado) between 2012 and 2014. Patient discharges for hospitalizations of people who had participated in a traffic collision in those same years were identified. The cost was obtained for each one of the patients discharged in the period of time referred above and it was compared to the cost of the patients who had been in a car collision. Costs were obtained using the Customer Service Cost Structure spreadsheet (ECAS spreadsheet) that is officially prepared by the Ministry of Public Health and the Diagnosis Related Groups.
Results: total expenditure was 27.610 with an average stay of 4 days. Discharges corresponding to collisions were 740, with an average stay of 7.5 days, almost double the average stay, and 851 days/bed in the ICU. 77% corresponded to motorcyclists, 65% of them were men, average age was 36 years old. The cost of healthcare services for these patients is 2.5 times higher than the cost of average.
Conclusions: The healthcare process of patients who participated in a car collision and are admitted to hospital is complex and test the institution´s continuity.
An average of 7.5 days of hospitalization should be considered for these patients and a cost that is 2.5 time higher than that of the average patient as a chance to improve healthcare services, creating effective interdisciplinary teams and specific clinical guidelines for this type of patients. They are becoming a new classification that is growing in number and shall require new forms of response.
References
(2) Unidad Nacional de Seguridad Vial. Sinatrán. Informe siniestralidad vial año 2014. Montevideo: UNASEV, 2014.
(3) Barrios Camponovo G. Enfermedad traumática en Uruguay: aspectos epidemiológicos. Rev Méd Urug 1995; 11(3):187-207.
(4) Garat H. Costos de los accidentes de tránsito en Uruguay. Montevideo: Comisión Nacional de Prevención y Control de Accidentes de Tránsito, 2000.
(5) Paolillo E, D’Agosto M, Díaz D, Macedo JC; Grupo Médico Migues. Anemias y morbilidad crónica en pacientes con 75 años y mayores, no agudamente enfermos. Rev Méd Urug 1990; 6(2):110-3.
(6) Mankin HJ. A computerized system for orthopaedic oncology. Clin Orthop Relat Res 2002; 398:252-61.
(7) Fetter RB, Shin Y, Freeman JL, Averill RF, Thompson JD. Case mix definition by diagnosis-related groups. Med Care 1980; 18(2 Suppl): iii, 1-53.
(8) Paolillo E, Russi U, Cabrera D, Martins L, Scasso A, Constantin M, et al. Grupos relacionados por el diagnóstico (RD): experiencia con IR-GRD en el Sanatorio Americano, sistema FEMI. Rev Méd Urug 2008; 24(4):257-65.
(9) Busse R, Geissler A, Quentin W, Wiley M, eds; European Observatory on Health Systems and Policies Series. Diagnosis-Related Groups in Europe. Moving towards transparency, efficiency and quality in hospitals. New York: Mc Graw Hill-Open University Press, 2011.
(10) Almenara Barrios J, García Ortega C, González Caballero JL, Abellán Hervás MJ. Creación de índices de gestión hospitalaria mediante análisis de componentes principales. Salud Pública Méx 2002; 44(6):533-40.
(11) Kaplan RS, Haas DA. How not to cut health care costs. Harv Bus Rev 2014; 92(11):116-22.
(12) Uruguay. Ministerio de Salud Pública. División Economía de la Salud. Instructivo ECAS: Estructura Costo Asistencia Socios. Información anual obligatoria y auditada que se envía año a año al Ministerio de Salud Pública, División Economía de la Salud. Montevideo: MSP, 2013.
(13) Torres Hinestroza A, López Orozco GM. Metodología de costos para instituciones prestadoras de servicios de salud: aplicación de los Grupos Relacionados por el Diagnóstico -GRD. El Hombre y la Máquina 2012; 40:31-43.
(14) Zafar A, Rohaizat MY, Muhd Nur A, Aljunid SM. The development of cost centres for case-mix costing in a teaching hospital in Malaysia. Malaysian J Public Health Med 2005; 5(Suppl 2):131-5.
(15) Amrizal MN, Rohaizat Y, Sulung S, Aljunid SM. Case-mix costing in Universiti Kebangsaan Malaysia Hospital: a top-down approach. Cost analysis for cardiology cases. Malaysian J Public Health Med 2005; 5(Suppl 2):33-44.
(16) Mayes R, Berenson RA. Medicare prospective payment and the shaping of U.S. health care. Baltimore: The Johns Hopkins University Press, 2006.
(17) Uruguay. Instituto Nacional de Estadística. Censos 2011. Montevideo: INE, 2011.
(18) Uruguay. Ministerio de Salud Pública. Indicadores básicos de salud Uruguay 2013. Montevideo: MSP, 2014.
(19) Uruguay. Sistema Nacional de Información. Información mensual obligatoria y auditada que se remite al Ministerio de Salud Pública, División Economía de la Salud. Montevideo: MSP, 2012.
(20) Marín León L, Belon AP, Barros M Berti de Azevedo, Almeida S Duarte de Mattos, Restitutti MC. Tendencia dos accidentes de tránsito en Campinas, Sao Paulo, Brazil: importancia crescente dos motociclistas. Cad Saúde Pública 2012: 28(1): 39-51.
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