Pediatric pedestrian injuries and associated hospital resource utilization in the United States, 2003

Abstract

Background: The objective was to calculate national estimates of pedestrian-related hospitalizations and associated use of healthcare resources among children <or=19 years of age and to explore the effects of sociodemographic, hospital-related factors, and injury severity on total charges and lengths of stay (LOS) in the United States.

Methods: Data from the 2003 Healthcare Cost and Utilization Project Kids' Inpatient Database were used. The sample included patients <or=19 years hospitalized with pedestrian-related injuries, from 3,438 hospitals in 36 states. National estimates of pedestrian-associated hospitalizations, rates, resource use, injury severity, and demographics were calculated. Potentially significant covariate associations were studied using hospital charges and LOS.

Results: In 2003, 9,172 pedestrian-associated hospitalizations occurred among children <or=19 years in the United States, resulting in USD 290.8 million (standard deviation [SD] = USD 23.6 million) in inpatient charges and 44,895 (SD = 2,964) days of hospitalization. Mean (SD) hospital charges and LOS were $32,059 ($74,778) days and 4.9 (10.9) days, respectively. Thirty-six percent of patients suffered a traumatic brain injury, and 21% sustained severe injury with an injury severity scale score >or=16. A traffic-related event was the cause of 92.7% of hospitalizations. Older age, higher injury severity, urban and Western hospital location, children's hospital type, and longer LOS were significantly associated with higher total hospital charges. Older age and higher injury severity were significantly associated with longer LOS.

Conclusion: Pediatric pedestrian injuries contribute substantially to the healthcare resource burden in the United States, accounting for approximately 45,000 days of hospitalization and >USD 290 million in inpatient charges annually.