The actual, long-term cost of intentional injury care among a cohort of Maryland Medicaid recipients
| Autor: | Ian Stockwell, Zachary D.W. Dezman, Paul Thurman |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Violence Critical Care and Intensive Care Medicine Article Intentional injury Ambulatory care Epidemiology medicine Humans health care economics and organizations Retrospective Studies Cost database Maryland Medicaid business.industry Patient Protection and Affordable Care Act Retrospective cohort study Evidence-based medicine United States Cohort Emergency medicine Wounds and Injuries Female Surgery business Self-Injurious Behavior |
| Zdroj: | J Trauma Acute Care Surg |
| ISSN: | 2163-0763 2163-0755 |
| DOI: | 10.1097/ta.0000000000003424 |
| Popis: | BACKGROUND Intentional injury (both self-harm and interpersonal) are major causes of morbidity and mortality, yet there is little data on the per-person cost of caring for these patients. Extant data focuses on hospital charges related to the initial admission but does not include actual dollars spent or follow-up outpatient care. The Affordable Care Act has made Medicaid the primary payor of intentional injury care (39%) in the United States and the ideal source of cost data for these patients. We sought to determine the total and per-person long-term cost (initial event and following 24 months) of intentional injury among Maryland Medicaid recipients. METHODS Retrospective cohort study of Maryland Medicaid claims. Recipients who submitted claims after receiving an intentional injury, as defined by the International Classification of Diseases, version 10, between October 2015 to October 2017. Subjects were followed for 24 months (last participant enrolled October 2017 and followed to October 2019). Our primary outcome was the dollars paid by Medicaid. We examined subgroups of patients who harmed themselves and those who received repeated intentional injury. RESULTS Maryland Medicaid paid $11,757,083 for the care of 12,172 recipients of intentional injuries between 2015 and 2019. The per-person, two-year healthcare cost of an intentional injury was a median $183 +/- $5,284 SD. These costs were highly skewed: Min = $2.56, Q1 = 117.60, median = $182.80, Q3 = $480.82, Max = $332,394.20. The top 5% (≥95% percentile) required $3,000 +/- $6,973 SD during the initial event and $8,403 +/- $22,024 SD per served month thereafter, or 55% of the overall costs in this study. CONCLUSIONS The long-term, per-person cost of intentional injury can be high. Private insurers were not included and may experience different costs in other states. LEVEL OF EVIDENCE Prognostic and Epidemiological Study, Level III. |
| Databáze: | OpenAIRE |
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