{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,6,9]],"date-time":"2024-06-09T17:32:55Z","timestamp":1717954375527},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,3,22]],"date-time":"2017-03-22T00:00:00Z","timestamp":1490140800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is a lack of information on annual healthcare expenditures both per person and for the U.S. population associated with trauma, as identified by International Classification of Disease Ninth Revision, Clinical Modification (<jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content>\u20109\u2010<jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content>) codes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This paper employed a two\u2010part model to estimate the unadjusted and adjusted annual per individual expenditures and population burden of trauma exposure for the U.S. population, using a nationally representative survey of medical care expenditures. In addition, we estimated a logit model to examine the demographic and comorbidity factors associated with the likelihood of experiencing trauma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Approximately 18.2% of U.S. adults were found to have trauma exposure during the survey year of 2011. The most frequent trauma <jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content>\u20109\u2010<jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content> code was injury not elsewhere classified\/not otherwise specified. Adjusted likelihood of trauma was higher among individuals under the age of 65; males; non\u2010Hispanic whites; nonmarried or never married; and individuals living with comorbidities of stroke, joint pain, arthritis, and asthma. The most expensive of the top 10 <jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content>\u20109\u2010<jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content> trauma codes was dislocation of the knee. Significant differences in expenditure categories were found for office\u2010based, outpatient, emergency department (<jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>), dental, and other medical care. After adjustment for comorbidities and demographics, the adjusted per\u2010person burden of trauma was estimated to be $1,689 (95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>]\u00a0=\u00a0$1,006 to $2,372), with an incremental burden on the U.S. population of $60.8 billion per year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Trauma results in a significant healthcare expenditure burden, both per person and on the U.S. population. Clinicians should be aware that individuals in the U.S. population with certain comorbidities such as stroke, joint pain, arthritis, and asthma are more likely to have trauma and that differences exist in expenditures for office\u2010based, outpatient, dental, and the <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.13143","type":"journal-article","created":{"date-parts":[[2016,12,15]],"date-time":"2016-12-15T18:14:42Z","timestamp":1481825682000},"page":"467-474","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Factors and Expenditures Associated With ICD\u20109\u2010CM Coded Trauma for the U.S. Population: A Nationally Representative Study"],"prefix":"10.1111","volume":"24","author":[{"given":"Clara E.","family":"Dismuke","sequence":"first","affiliation":[{"name":"Center for Health Disparities Research Department of Medicine Medical University of South Carolina Charleston SC"},{"name":"Department of Medicine Division of General Internal Medicine and Geriatrics Medical University of South Carolina Charleston SC"},{"name":"Health Equity and Rural Outreach Innovation Center (HEROIC) Ralph H. Johnson Veterans Affairs Medical Center Charleston SC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kinfe G.","family":"Bishu","sequence":"additional","affiliation":[{"name":"Center for Health Disparities Research Department of Medicine Medical University of South Carolina Charleston SC"},{"name":"Department of Medicine Division of General Internal Medicine and Geriatrics Medical University of South Carolina Charleston SC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samir","family":"Fakhry","sequence":"additional","affiliation":[{"name":"Department of Surgery Medical University of South Carolina Charleston SC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebekah J.","family":"Walker","sequence":"additional","affiliation":[{"name":"Center for Health Disparities Research Department of Medicine Medical University of South Carolina Charleston SC"},{"name":"Department of Medicine Division of General Internal Medicine and Geriatrics Medical University of South Carolina Charleston SC"},{"name":"Health Equity and Rural Outreach Innovation Center (HEROIC) Ralph H. Johnson Veterans Affairs Medical Center Charleston SC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonard E.","family":"Egede","sequence":"additional","affiliation":[{"name":"Center for Health Disparities Research Department of Medicine Medical University of South Carolina Charleston SC"},{"name":"Department of Medicine Division of General Internal Medicine and Geriatrics Medical University of South Carolina Charleston SC"},{"name":"Health Equity and Rural Outreach Innovation Center (HEROIC) Ralph H. Johnson Veterans Affairs Medical Center Charleston SC"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,3,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6438a4"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000910"},{"key":"e_1_2_6_4_1","unstructured":"Agency for Healthcare Research and Quality (AHRQ).The Concentration of Health Care Expenditures and Related Expenses for Costly Medical Conditions 2012. Available at:http:\/\/meps.ahrq.gov\/mepsweb\/data_files\/publications\/st455\/stat455.pdf. Accessed Aug 22 2014."},{"key":"e_1_2_6_5_1","unstructured":"Agency for Healthcare Research and Quality (AHRQa).Methodology Report # 27 Sample Design of the 2011 Medical Expenditure Panel\u00a0Survey Insurance Component 2013a. Available at:http:\/\/meps.ahrq.gov\/data_files\/publications\/mr27\/mr27.pdf. 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