28 PAEDIATRIC TRAUMA SERVICE - IS IT COST EFFECTIVE?
Jennifer Billington, Joe Davidson, Erica Makin
king's college hospital, London, United Kingdom

Abstract

Aim:

The cost of treating paediatric trauma patients is believed to be significant, but is largely unknown. Each trust submits data to The Trauma Audit and Research Network(TARN) for patients meeting their reportable criteria. In return trusts receive a Best Practice Tariff(BPT).

We aimed to calculate the cost of all acute trauma admissions and identify cost predictors for children aged <16yrs in a UK Major Trauma Centre.

 

Method:

Retrospective review of all paediatric trauma admissions over 12 months (Apr 2016 -Apr 2017).TARN and NHS National Treatment Tariffs were used. Multivariate linear regression modelling was performed, using the dependent variable of overall admission cost per patient, independent variables ISS, PICU days, LOS, patient age, cost of surgery and  imaging. Results are reported as median(range). 

Results:

A total of 316 patients divided into Group 1(TARN reportable n=91(29%)) & Group 2(Non-TARN reportable n=225(68%) [Table 1] made an overall sum of £1,736,187.00.

The income made from Group 1 was significantly greater than group 2 (£1,025,615 vs £710,572) p=<0.0001 MWU. Partly attributable to TARN reportable patients merited with a Best Practice Tariff (BPT). Level 2 BPT received for n=46(51%)- £133,998 & level 1 BPT for n=33(36%) - £49,995.

A higher proportion of Group 1 patients n=37(41%) vs n=49(22%) in group 2 required surgery (p=0.0005). Patients with a younger age,  higher ISS, longer LOS, more PICU days & surgery cost significantly more. (p<0.0001 Spearmans Rank). 

Conclusion:

Trauma care is complex and expensive. The higher proportion of TARN reportable patients you treat, the greater the financial reward.

Table 1: Patient Demographics

 

TARN

Non-TARN

Number of patients

Age

91

9.7y (0.0- 5.9)

225

10.1y (0.1-16.0)

ISS

16 (4-54)

4 (0-65)

Length of stay (days)

5 (1-47)

1 (0-48)

PICU stay (days)

0 (0-26)

0 (0-9)

 


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