Abstract
Introduction
Government figures show a trend of increasing incidence in motorcycle trauma in the UK over the last decade. These patients often have multiple injuries and place a significant burden on the admitting units. In the face of changes to health service funding, with the introduction of Payment by Results, we wanted to determine the true cost of treating these patients in the setting of a District General Hospital.
Methods
We undertook a retrospective case-note review of all the motorcyclists involved in road traffic accidents (MRTAs) requiring admission for treatment in 2004. Patients were identified using the hospital computer system. A supplementary telephone survey was also undertaken to retrieve information not previously recorded. The following parameters were analysed: demographic and admission details, motorcycle and accident details, admitting specialty, injury pattern, nature and number of investigations, treatment, outcome and cost.
Results
Of 103 MRTAs attending the Accident & Emergency Department, 33 required admission. 25 required surgical intervention: 23 underwent fracture fixation, 3 underwent a laparotomy and 13 underwent soft tissue surgery as a primary procedure. Multiple procedures were required in a large proportion of patients with 18% requiring 4 or more operations. In total 119 hours of theatre time were utilised. Multiple investigations were required with a mean of 12.2 radiographs and 1.2 CT scans per patient. 5 patients required ITU admission, 3 High Dependency and 25 were admitted to the ward, with a mean length of stay of 14.5 days. This accounted for the majority (67%) of the hospital costs. The mean total cost per patient was £11,140 GBP (€16,151).
Conclusions
This study highlights the high cost associated with motorcycle trauma and the need for appropriate tariffs that recognise this.
