Factors associated with hospital length of stay and hospital charges of motor vehicle crash related hospitalizations among children in the United States

Ricky Gardner, Gary A Smith, Anne-Marie L Chany, Soledad A Fernandez, Lara B McKenzie
Archives of Pediatrics & Adolescent Medicine 2007, 161 (9): 889-95

OBJECTIVES: To calculate national estimates of motor vehicle crash (MVC)-related hospitalization and associated use of health care resources among patients 20 years and younger and to explore the effects of certain sociodemographic and health care system-related factors and injury severity on use of hospital resources and lengths of stay (LOSs) in the United States.

DESIGN: Data from the 2003 Healthcare Cost and Utilization Project Kids' Inpatient Database were used.

SETTING: Pediatric inpatient care in 3438 hospitals in 36 US states. Patients Patients 20 years and younger hospitalized with MVC-related injuries.

MAIN OUTCOME MEASURES: National estimates of MVC-associated hospitalizations, rates, resource use, Injury Severity Scores, and demographics were calculated. Potentially significant covariate associations were studied using hospital charges and LOS.

RESULTS: Sixty-two thousand eight hundred eighty MVC-related hospitalizations occurred among patients 20 years and younger in the United States in 2003, resulting in more than $2.0 billion (SD = $1.2 million) in inpatient charges and 304 196 days (SD = 55,113 days) of hospitalization. Mean (SD) hospital charges and LOS were $33,440 ($55,113) and 4.8 (7.7) days, respectively. The mean (SD) Injury Severity Score was 10.3 (11.4). Adolescents aged 18 through 20 years had the highest hospitalization rates (197 cases per 100,000 children). Older age, being male, urban hospital location, mortality during hospitalization, higher injury severity, and longer LOS were significantly associated with higher total charges. Longer LOS was significantly associated with older age, urban hospital location, higher injury severity, and mortality.

CONCLUSION: Motor vehicle crash-related injuries among children burden health care resources, with nationwide charges exceeding $2 billion annually.

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