Cost And Resource Demand Of Major Trauma In Northland
H Lee*, O Monos **, C Harmston ***
* Surgical Registrar, Department of General Surgery, Whangarei Hospital, Northland DHB
** Trauma Coordinator, Whangarei Hospital, Northland DHB
*** Surgical Consultant, Department of General Surgery, Whangarei Hospital, Northland DHB
Introduction:
Trauma is an important cause of morbidity and mortality in New Zealand, and also represents a significant
financial and resource burden on the healthcare system. Understanding local costs and resource demand
is important for planning of trauma services.
Aim:
The objective of this study was to evaluate the financial and resource requirements of major trauma in
Northland.
Methods:
Patients admitted to Whangarei Hospital suffering from major trauma from January to December 2015
were identified from the hospitals prospectively maintained trauma database. Major trauma was defined
as an Injury Severity Score (ISS)>12, admission to intensive care or death secondary to trauma.
Actual costs were computed using in-house clinical patient level costing using Costmaker software. Caseweight costs were obtained using national DRG codes.
Results:
A total of 92 patients had reportable events.
79% of patients were admitted under the care of a general surgeon. There was a seasonal variation in
admission with 42 % being admitted during summer. 54% of patients required ICU admission, including 18
(36%) of patients with an ISS ≤12.
Cost data was available for 83 of the primary cohort.
Total actual costs were $1.68 million, with an average expenditure of $20, 296 per patient (Range $364 $136, 621). Total case weight costs were $1.04 million with an average spending of $12, 511 per patient
(Range $895 - $63, 593). The cost deficit (actual - case-weight cost) was $ 704, 226.
Costs were highest in patients admitted to ITU, regardless of ISS.
Conclusion:
The financial and resource burden of major trauma on Northland DHB is substantial, the majority sitting
with general surgery. There is a discrepancy between actual and case-weight costs as well as a seasonal
variation in presentation.