Table 1.
Trends in TBI charges for admitted patients
| Charges per visit, US$ (mean, 95% CI) 2006 |
Charges per visit, US$ (mean, 95% CI) 2010 |
Difference in Charges (mean, 95% CI) |
|
|---|---|---|---|
| Total, admitted | 58,569 (52,693–64,444) | 67,224 (61,091–73,357) | 8,656 (167–17,144) |
| Age | |||
| <3 years | 30,185 (23,734–36,636) | 33,961 (27,157–40,764) | 3,776 (−5,593–13,145) |
| 3–17 years | 46,258 (40,419–52,096) | 53,301 (44,052–62,551) | 7,028 (−3,909–17,966) |
| 18–44 years | 68,976 (61,826–76,126) | 81,744 (73,237–90,251) | 12,768 (1,662–23,874) |
| 45–59 years | 70,744 (63,231–78,256) | 82,702 (74,476–90,928) | 11,958 (825–23,092) |
| ≥60 years | 48,776 (43,551–54,000) | 55,940 (51,940–59,991) | 7,164 (558–13,771) |
| Sex | |||
| Male | 63,858 (57,388–70,328) | 74,354 (67,675–81,032) | 10,496 (1,202–19,789) |
| Female | 49,565 (44,707–54,423) | 56,213 (50,943–61,482) | 6,648 (−516–13,811) |
| Insurance status | |||
| Private | 63,110 (56,750–69,471) | 73,341 (64,996–81,687) | 10,248 (−217–20,712) |
| Medicare | 44,809 (40,267–49,351) | 53,688 (49,745–57,630) | 8,890 (2,886–14,894) |
| Medicaid | 75,228 (64,740–85,716) | 92,478 (80,633–104,324) | 17,253 (1,467–33,040) |
| Self-pay | 54,867 (46,546–63,187) | 61,313 (52,704–69,922) | 6,456 (−5,495–18,407) |
| No Charge/Other | 67,434 (59,934–74,933) | 72,314 (65,270–79,358) | 4,902 (−5,375–15,180) |
| Income | |||
| 0–25th Percentile | 57,034 (49,638–64,429) | 68,750 (61,246–76,254) | 11,716 (1,187–22,246) |
| 25–50th | 55,966 (49,892–62,039) | 66,430 (60,531–72,330) | 10,465 (2,002–18,927) |
| 51–75th | 59,109 (52,272–65,947) | 70,593 (62,707–78,479) | 11,484 (1,052–21,916) |
| 76–100th | 60,972 (53,840–68,104) | 62,615 (53,657–71,574) | 1,643 (−9,800–13,087) |
| [Other (Zip blank or miss] | 69,442 (60,813–78,070) | 68,194 (55,032–81,358) | –1,247 (−16,976–14,481) |
| Region | |||
| Northeast | 63,898 (47,884–79,912) | 47,088 (40,098–54,077) | −16,810 (−34,218–598) |
| Midwest | 37,775 (34,186–41,365) | 55,379 (48,437–62,321) | 17,604 (9,803–25,405) |
| South | 52,702 (43,068–62,336) | 71,076 (58,323–83,828) | 18,374 (2,419–34,328) |
| West | 80,114 (68,153–92,074) | 87,896 (73,645–102,147) | 7,782 (−10,756–26,321) |
| ICD9-CM diagnosis | |||
| 850 (Concussion) | 43,298 (37,311–49,285) | 50,203 (42,494–57,912) | 6,905 (−2,850–16,660) |
| 800–801.9; 803–804 (Skull Fracture) | 80,060 (71,437–88,682) | 95,085 (85,248–104,922) | 15,026 (1,952–28,099) |
| 851 (Cerebral laceration and contusion) | 66,844 (59,966–73,723) | 71,142 (65,764–76,521) | 4,298 (−4,429–13,025) |
| 852.0, 852.1 (Subarachnoid hemorrhage) | 70,012 (60,178–79,847) | 73,717 (66,285–81,150) | 3,705 (−8,615–16,025) |
| 852.2, 852.3 (Subdural hemorrhage) | 61,878 (55,431–68,325) | 66,684 (62,228–71,328) | 4,900 (−2,986–12,786) |
| 852.4, 852.5 (Epidural hemorrhage) | 60,542 (48,709–72,375) | 82,787 (70,951–94,623) | 22,245 (5,552–38,968) |
| 853 (Intracranial hemorrhage, unspecified) | 66,043 (56,185–75,900) | 69,684 (62,653–76,714) | 3,641 (−8,460–15,741) |
| 854.0–854.1 (Brain injury, other) | 60,649 (43,561–77,736) | 72,193 (55,658–88,728) | 11,544 (−12,218–35,307) |
| 959.01 (Head injury, unspecified) | 28,195 (25,547–30,843) | 37,274 (32,715–41,834) | 9,079 (3,809–14,349) |
| Injury Severity Score | |||
| ISS ≤ 8 | 25,058 (23,013–27,102) | 30,415 (27,590–33,241) | 5,358 (1,872–8,843) |
| ISS 9–15 | 52,566 (47,419–57,713) | 58,996 (53,713–64,278) | 6,430 (−941–13,801) |
| ISS ≥ 16 | 90,366 (80,075–100,656) | 98,648 (89,619–107,677) | 8,283 (−5,399–21,964) |
| Trauma center | 69,131 (61,960–76,303) | 76,478 (68,810–84,147) | 7,347 (−3,109–17,803) |
| Non-trauma center | 29,589 (27,623–31,556) | 38,089 (35,272–40,906) | 8,500 (5,067–11,933) |
| Teaching hospital | 63,045 (55,327–70,763) | 71,678 (63,160–80,196) | 8,633 (−2,826–20,093) |
| Non-teaching hospital | 50,151 (42,243–58,060) | 57,930 (52,625–63,234) | 7,778 (−1,737–17,294) |
| Pediatric hospital | 29,559 (24,838–34,280) | 24,124 (17,439–30,809) | –5,435 (−13,459–2,589) |
| Non-pediatric hospital | 59,222 (53,292–65,152) | 67,789 (61,716–73,861) | 8,567 (84–17,049) |
| Metropolitan Area | 60,913 (54,868–66,958) | 69,035 (62,706–75,365) | 8,122 (−623–16,866) |
| Non-metropolitan Area | 17,322 (13,891–20,754) | 24,951 (13,889–36,014) | 7,629 (−3,934–19,193) |
| Hospital ownership | |||
| Government or private | 63,062 (56,615–69,510) | 70,782 (63,928–77,636) | 7,720 (−1,679–17,118) |
| Government, nonfederal | 26,379 (16,383–36,374) | 36,214 (24,241–48,186) | 9,835 (−5,694–25,364) |
| Private, non-profit | 28,945 (24,689–33,201) | 41,808 (35,761–47,855) | 12,863 (5,493–20,233) |
| Private, investor-owned | 37,823 (33,345–42,302) | 46,518 (40,548–52,488) | 8,695 (1,272–16,118) |
| Private, not specified | 22,140 (15,662–28,619) | 40,563 (19,343–61,783) | 18,423 (−3,616–40,461) |
Abbreviations: TBI= traumatic brain injury; US= United States; ICD9-CM= International Classification of Diseases, 9th revision, Clinical Modification