Demographics and Geographical Distribution
In all, 39,657 patients were included in the study, with 273 being excluded for medical accidents, medication errors, and poisonings. The remaining 39,384 were included in the analysis. Demographic information and regional breakdowns are found in , and injury information is found in .
Table 1: Patient Demographic Information
Table 2: Injury and Accident Information
All patients included in this study were under the age of 18, with an average age of 6.28 years (standard deviation of 5.7). Over the five year period, sixty-four percent of the population was male (n = 25,187). The majority of the patients in the sample had government health insurance (n = 16,218), thirty-one percent were on private insurance (n = 11,995), almost seventeen percent were on “other insurance” (n = 6,506), and almost twelve percent did not have listed insurance status (n = 4,665).
The majority of the patients lived in urban towns (79%, n = 31,065), followed by large towns (9%, n = 3,696), small towns (5%, n = 1,915), and then isolated towns (3%, n = 1,223). Resident town size was not listed in almost four percent of the sample (n = 1,485). A map of the regional breakdown is found in Figure 1
Injury Status, Outcome, and Accident Information
Over three-quarters of the patients captured in this dataset were diagnosed with a head injury as the primary diagnosis (n = 30,061), and almost one-quarter of the patients had diagnosed head injuries secondary to another injury (n = 9,323).
Almost seventy percent of the patient population was injured through an accidental mechanism (n = 27,606), and almost nine percent were injured through non-accidental means (n = 3,378). Approximately twenty-one percent of the patients had an unknown causal type or the cause was not listed (n = 492 and 7,908, respectively).
A majority of the patients were discharged home (92%, n = 36,131), with “other” as the next most common discharge disposition (3.0%, n = 1,201). Three percent of the population died (n = 1,173), and one percent went to a skilled facility at discharge (n = 488). One percent of the patient population were also discharged into a Home Heath Service (n = 391).
Chi-square analysis further yields significant differences for type of diagnosed head injury (primary or secondary), type of injury, and discharge disposition (p < 0.01). Patient Injury Status and Outcome information can be found in .
Mechanism of Injury and Billed Charges
Twenty percent of the population did not have an identifiable e-code listed (n = 7,908). However, the most common mechanisms of injuries were falls (n = 11,535), all motor vehicle-related crashes (n = 8,251), and abuse/assaults (n = 3,299). These three mechanism areas represent almost fifty-nine percent of the total injuries. In this instance, motor vehicle-related crashes included motor vehicle collisions, motor vehicle accidents, motor pedestrian collisions, and “other motor vehicle accidents.”
Overall, the total billed charge for these patients was $1.73 billion dollars over the past five-year period. Approximately six percent of the population had no billed charges listed (n = 2,354), and one patient had a billed credit. Excluding these patients from the analysis, the average billed charges in treating these patients was $46,784 (Md $18,369). The average length of ICU stay for these patients was 5.3 days (Md 2 days), ranging from 1 to 1,534 days. The most expensive billed charge was $7.8 million.
Overall, government insurance was billed an average of $52,357 per patient (Md $20,104), private insurance was billed an average of $43,763 per patient (Md $17,615), other insurance was billed an average of $40,929 per patient (Md $16,244), and those with no insurance listed were billed an average of $42,998 per patient (Md $17,510).
For the top ten most common injuries, the total billed charges and the average charges for those injuries are found in , and , respectively. Motor vehicle collisions and crashes, falls, and assaults/abuses not only account for over half of the injuries, but also account for half of the billed charges over the five-year period. Motor vehicle crashes account for $406.3 million in billed charges over the five-year period, with falls accounting for $244.3 million, and assault/abuse accounting for another $219.5 million in billed charges. Combined, these three areas account for almost $1 billion in billed charges over the five-year period. The top ten most expensive injuries by billed charges are found in , and the top ten most expensive injuries by average cost per injury are found in .
Table 3: Top 10 Most Common Head Injury Causes between 2006 and 2010
Table 4: Top 10 Most Expensive Head Injury Causes Between 2006 and 2010 (gross)
Table 5: Top 10 Most Expensive Head Injury Causes Between 2006 and 2010 (average)
It should be reiterated that almost twenty percent (n = 7,549) of the study sample had no E-codes listed. These patients account for $461.4 million of the total sum, and an average billed charge of $61,124 per patient. These totals rank first, and tenth in the total billed charges and average billed charge, respectively.