1. 1 Hospital Charges For Patients Involved in Motor Vehicle Crashes in Nebraska 1996-2000 Ming Qu Prabhakar Dhungana

2. 2 Introduction Motor vehicle crashes (MVCs) are one of the top five leading causes of injury in Nebraska Source: Nebraska 2001 ECODE File

3. 3 Introduction (Continued) MVCs result in significant economic costs –Around $2 billion each year in Nebraska However very limited information was available about the financial outcomes of MVCs Hospital charges represent the retail price for patient services before discount Used to estimate actual costs

4. 4 Objective Help understand the factors which contribute to motor vehicle crashes- related health care costs to prioritize safety measures

5. 5 Methods Nebraska CODES Data 1996-2000  Motor vehicle crash records linked with hospital discharge records This study includes:  Records related to crashes involving cars, vans and light trucks; and  Records containing information on hospital charges

6. 6 Methods (contd.) Descriptive Response variables  Hospital charges Factors  Person specific  Age, Gender, Restraint use, Driver condition  Body Part Injured  Crash specific  Contributing human factors, Crash type, Posted speed limit

7. 7 Overview of Study Population Total number of patients (hospital charge>0) 31,574 –Patient type Inpatient 3,263 (10%) Outpatient 28,311 (90%) –Gender Female 18,278 (58%) Male 13,296( 42%)

8. 8 Number of Patients (31,574) Total Hospital Charges (77,111,383)

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10. 10 Hospital Charges by Age Group for Patients Involved in Motor Vehicle Crashes. Nebraska, 1996-2000 Age PatientsHospital Charges N%Mean $Median $ Total Sum $% 0-45521.7 1,242138685,4120.9 5-97792.5 1,181180920,0641.2 10-141,3054.11,9142922,497,7473.2 15-197,90225.01,86132814,707,66519.1 20-244,46714.12,1133479,528,59012.4 25-345,33216.92,03535510,850,14214.1 35-444,37313.92,39238310,461,24613.6 45-542,8309.02,8604128,094,01810.5 55-641,5805.03,6274305,731,3477.4 65-741,3074.14,7804526,247,9728.1 75 or older1,1473.66,4405967,387,1799.6

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12. 12 Hospital Charges by Driver Condition for Patients Involved in Motor Vehicle Crashes in Nebraska, 1996-2000 Driver Condition PatientsHospital Charges N%Mean $Median $ Total Sum $% Not Stated2390.84,4504091,063,4471.4 Normal26,80384.91,77333647,519,75661.6 Fatigue/Asleep3781.24,4686201,688,7882.2 Illness1330.49,3858021,248,2181.6 Drinking2,1076.76,38374513,449,89117.4 Illegal Drug290.13,04777688,3730.1 Medication520.22,497654129,6910.2 Unknown1,6365.26,54750310,711,33413.9 Other1480.55,790617856,8661.1 Missing490.27,2451,219355,0200.5

13. 13 Hospital Charges by Major Contributing Human Factor for Patients Involved in Motor Vehicle Crashes in Nebraska, 1996-2000 Major Contributing Human Factor PatientsHospital Charges N%Mean $Median $ Total Sum $% Speeding or Too Fast3,94312.53,48141613,726,49217.8 Right of Way Violation11,97837.92,14035125,632,05033.2 Ran Stop Sign1,3994.43,0073984,207,3875.5 Ran Traffic Signal2,4697.82,1203495,233,3926.8 Failure to Yield8,11025.71,99634516,191,27221.0 Following Too Close4,55814.48613073,924,5005.1 Improper Turn5211.71,901336990,5001.3 Improper Lane Change2750.91,765358485,3480.6 Drove Left of Center1,0663.47,2525597,730,63710.0 Evasive Action1,3944.42,5083633,496,5644.5 Improper Overtaking4231.32,4123361,020,3761.3 Other4,62614.72,77438412,831,98616.6 None1,7375.52,3023443,999,2375.2 Not Stated1,0533.33,1093533,273,6944.2

14. 14 Hospital Charges by Crash Type for Patients Involved in Crashes in Nebraska, 1996-2000 Crash Type PatientsHospital Charges N%Mean $ Median $ Total Sum $% Rollover1,8125.74,4304408,026,64610.4 Single Vehicle Fixed Object4,55014.44,05048518,426,36123.9 Single Vehicle Non-fixed Object8912.83,3023612,941,7823.8 Multiple Vehicle Non Head- on23,51174.51,85733343,660,85756.6 Multiple Vehicle Head-on5241.75,6155472,942,0813.8 Other1100.37,695889401,1350.5 Missing1760.68,501462712,5210.9

15. 15 Table 5. Hospital Charges by Body Part Injured* for Patients Involved in Motor Vehicle Crashes in Nebraska, 1996-2000 Body Part Injured PatientsHospital Charges N%Mean $Median $ Total Sum $% Head6,29119.92,98538818,779,74824.4 Whole Body9963.210,73380610,689,65413.9 Chest2,0136.43,7214847,491,3739.7 Neck6,47520.51,0953337,092,4589.2 Back3,22210.21,6193715,217,5696.8 Abdomen7812.56,3146464,930,9346.4 Lower Leg1,9276.12,3343464,497,9725.8 Hip7032.26,2014684,359,5395.7 Missing28579.01,2692663,621,6654.7 Face1,9826.31,6823693,334,0634.3 Unknown10873.42,5182842,737,0013.5 Lower Arm1,7065.41,2843222,190,6162.8 Shoulder1,5344.91,4143492,168,7922.8 * Body part injured is defined according to police report

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17. 17 Summary Hospital Charges were higher for patients who were –Male –Older –Unrestrained –Involved in alcohol-related crashes –Involved in crashes caused by driving left of center and speeding –Involved in multiple vehicle head on crashes

18. 18 Summary (Continued) –Patients with “whole body” injuries had the largest median hospital charges –Patients with “head” injuries accounted for the largest of the total hospital charges –Median hospital charges generally increased as the posted speed limit increased