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pubmed-article:2056547pubmed:abstractTextEconomic issues threaten the development of a national trauma system. Much work has focused on the cost of trauma care; little has been done to define society's long-term economic return. We asked three questions about high cost trauma patients: (1) Do they survive?, (2) Do they continue to require expensive care?, and (3) Do they return to productivity? Of 6,129 consecutive trauma admissions, 114 had hospital charges over $100,000 (mean = $143,000), 102 (89.5%) were discharged alive, and 10 (8.8%) were lost to followup. Ninety-two patients or families were interviewed at least 1 year (mean = 2.6 year) after discharge. There were 88 survivors and 4 deaths (3.5%). Of the 88 survivors 73% had no limitation of ADLs, 67% received rehabilitation, 58% were still improving, and 37% were involved in litigation. Five survivors (5.7%) were confined to a nursing home, 48 (54.5%) had returned to productivity (RTP), 35 (39.8%) were unemployed, and five of these still require medical therapy. We conclude: (1) The majority of high cost patients survive (89.5%) and return to productivity (54.5%); (2) the severity of injury predicts survival but not return to productivity; and (3) the RTP rate may be increased by addressing nonmedical need.lld:pubmed
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pubmed-article:2056547pubmed:pagination827-33; discussion 833-4lld:pubmed
pubmed-article:2056547pubmed:dateRevised2004-11-17lld:pubmed
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pubmed-article:2056547pubmed:articleTitleTrauma patients return to productivity.lld:pubmed
pubmed-article:2056547pubmed:affiliationDivision of Trauma, Vanderbilt University School of Medicine, Nashville, TN 37212.lld:pubmed
pubmed-article:2056547pubmed:publicationTypeJournal Articlelld:pubmed
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