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A comparative study of hospital resource allocation between elderly casualties and the remaining population, and among ethnic groups
Researchers: Kobi Peleg1, Bella Savitsky1
- The Gertner Institute for Epidemiology and Health Policy Research
Background: Studies report a high percentage of injury among the elderly and among minority ethnic groups in comparison to their proportion in the population. The ethnic mix of Israeli residents in general and the elderly in particular, in relation to injuries and consumption of hospital resources, has yet to be studied in Israel.
Objectives: 1. To examine differences in injury characteristics and allocation of hospitalization services between the elderly group and other casualties and between ethnic groups.
2. To analyze the trend of injuries and the use of hospitalization services during the past years.
3. To compare the hospitalization costs calculated by two methods: using the daily hospitalization fee with length of stay (LOS) and based on Diagnosis Related Group (DRG) for trauma, developed by the Center for Trauma and Emergency Medicine Research in the Gertner Institute.
2. To analyze the trend of injuries and the use of hospitalization services during the past years.
3. To compare the hospitalization costs calculated by two methods: using the daily hospitalization fee with length of stay (LOS) and based on Diagnosis Related Group (DRG) for trauma, developed by the Center for Trauma and Emergency Medicine Research in the Gertner Institute.
Method: A retrospective study based on data from the Israeli National Trauma Registry, which includes patients hospitalized due to injury between the years 2008-2013.
Findings: • During the study period a constant increase in the yearly number and proportion of patients aged 65+ was found.
• Injury severity of patients aged 65+ is higher in comparison with those aged 0-64 (65% vs. 25% of moderate, severe and critical injuries). Patients aged 65+ had longer hospitalization length (median 6 days vs. 2 days) and higher hospitalization costs (median 20,072 NIS vs. 5,770 NIS).
• Most of the patients aged 65+ were hospitalized following falls (86%). Among patients aged 65+ from the Ethiopian origin frequency of RTA was higher (most of the injured in RTA were pedestrians).
• Hospitalization costs calculated using daily hospitalization fees result in significant underpayment regarding actual hospitalization costs of severely injured patients aged 65+.
• Injury severity of patients aged 65+ is higher in comparison with those aged 0-64 (65% vs. 25% of moderate, severe and critical injuries). Patients aged 65+ had longer hospitalization length (median 6 days vs. 2 days) and higher hospitalization costs (median 20,072 NIS vs. 5,770 NIS).
• Most of the patients aged 65+ were hospitalized following falls (86%). Among patients aged 65+ from the Ethiopian origin frequency of RTA was higher (most of the injured in RTA were pedestrians).
• Hospitalization costs calculated using daily hospitalization fees result in significant underpayment regarding actual hospitalization costs of severely injured patients aged 65+.
Conclusions: • The prevention program is needed to stop the increase in the number of hospitalized following injury aged 65+.
• Implementation of DRG, developed by the Center for Trauma and Emergency Medicine Research in Gertner Institute is needed to prevent underpayment to the hospitals following treatment of severe injured patients aged 65+.
• Implementation of DRG, developed by the Center for Trauma and Emergency Medicine Research in Gertner Institute is needed to prevent underpayment to the hospitals following treatment of severe injured patients aged 65+.
Research number: R/77/2014
Research end date: 04/2017