Abstract
BackgroundComorbidity is known to affect length of hospital stay and mortality after trauma but less is known about its impact on recovery beyond the immediate post-accident care period. The aim of this study was to investigate the role of pre-existing health conditions in the cost of recovery from road traffic injury using health service use records for 1 year before and after the injury.MethodsIndividuals who claimed Transport Accident Commission (TAC) compensation for a non-catastrophic injury that occurred between 2010 and 2012 in Victoria, Australia and who provided consent for Pharmaceutical Benefits Scheme (PBS) and Medicare Benefits Schedule (MBS) linkage were included (n = 738) in the analysis. PBS and MBS records dating from 12 months prior to injury were provided by the Department of Human Services (Canberra, Australia). Pre-injury use of health service items and pharmaceuticals were considered to indicate pre-existing health condition. Bayesian Model Averaging techniques were used to identify the items that were most strongly correlated with recovery cost. Multivariate regression models were used to determine the impact of these items on the cost of injury recovery in terms of compensated ambulance, hospital, medical, and overall claim cost.ResultsOut of the 738 study participants, 688 used at least one medical item (total of 15,625 items) and 427 used at least one pharmaceutical item (total of 9846). The total health service cost of recovery was $10,115,714. The results show that while pre-existing conditions did not have any significant impact on the total cost of recovery, categorical costs were affected: e.g. on average, for every anaesthetic in the year before the accident, hospital cost of recovery increased by 24 % [95 % CI: 13, 36 %] and for each pathological test related to established diabetes, hospital cost increased by $10,407 [5466.78, 15346.28]. For medical costs, each anaesthetic led to $258 higher cost [174.16, 341.16] and every prescription of drugs used in diabetes increased the cost by 8 % [5, 11 %].ConclusionsServices related to pre-existing conditions, mainly chronic and surgery-related, are likely to increase certain components of cost of recovery after road traffic trauma but pre-existing physical health has little impact on the overall recovery costs.
Highlights
Comorbidity is known to affect length of hospital stay and mortality after trauma but less is known about its impact on recovery beyond the immediate post-accident care period
The Transport Accident Commission (TAC) is a state-government organisation responsible for paying the cost of treatment rehabilitation services, disability services, income assistance, travel and household support services to people injured in traffic accident in the state of Victoria regardless of whether the client was at fault
Informed consent for inclusion in the study with both Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) data linkage was obtained from 738 TAC clients (i.e.7 %)
Summary
Comorbidity is known to affect length of hospital stay and mortality after trauma but less is known about its impact on recovery beyond the immediate post-accident care period. The social costs of road traffic crash injury in Australia in 2006 were estimated to be $18,000 million, which is equal to about 1.7 % of the GDP. Sixty seven percent of these injured people stayed one or more nights at the hospital and 4619 people suffered disability, from which 1270 people had “severe or profound limitation”. Cost of these injuries were approximately $2.4 million per fatality, approximately $214,000 per hospitalised injury (including disability-related costs), and approximately $2200 per non-hospitalised injury” [3]
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