Case-based hospital billing data from the Health Care Utilization Partnership was used to calculate annual statewide hospital charges for the acute care of traffic injuries in Nebraska. E-codes 810.0 through 819.9 identified traffic injury cases. Admissions and emergency department (ED)-only visits for traffic injuries accrued significantly higher charges than other types of care. Statewide, hospital charges for the acute care of traffic injury totaled more than U.S.$63.8 million in 2004. Of this, 23.2% was charged to public payers (Medicare or Medicaid) and 5.5% was charged to self-pay (generally accepted as bad debt absorbed by the hospital system). Much work has been performed looking at community or population level costs of acute care for road traffic injuries, but most of it has used stratified samples of crash data and averaged costs (Blinkcoe, 2002) or identified cases via automobile insurance reports and then sought health cost information (Jacobs, 2004) (limited by patients’ reporting to their auto insurer (Lemstra, 2005)). For states with Crash Outcomes Data Evaluation Systems (CODES) police reports are linked with hospital records (including billing). This linkage supplies additional information but many records fail to link, limiting what gross statewide economic conclusions can be drawn. With the availability of a new data source, the Health Care Utilization Partnership (HCUP, http://www.hcup-us.ahrq.gov/ ) there are new opportunities to understand the costs of acute care for traffic injuries and their impact on health care. HCUP produces various datasets designed to be a census of billing data from acute medical care admissions and Emergency Department (ED) visits in specific states. Over the last several years, the level of E-coding (external cause of injury coding) has risen in a few states to the point where we can use the E-codes to accurately identify injuries related to motor vehicle crashes. (Author/publisher)
Abstract