Increased consumption of hospital resources due to complications: an assessment of costs in a level I trauma center

J Trauma. 2011 Nov;71(5):E102-9. doi: 10.1097/TA.0b013e31820e351f.


Background: Hospital complications can pose a threat to patients, contribute to higher mortality and morbidity, and increase both the average length of hospital stay (LOS) and the use of other resources. The purpose of this study is to express the relationship between complications and the use of hospital resources in financial parameters.

Methods: All trauma patients admitted to the surgical ward in the period 2000 to 2008 were analyzed (n = 4,377). All activities registered during admission were obtained. The integral in-hospital cost prices of each activity were divided into various product groups. Median and interquartile ranges were presented for the number of activities in the product groups, stratified by age and Injury Severity Score. The relationship between both institutional- and trauma-related complications and the number of activities in the different product groups was tested with linear regression analysis with adjustment for confounding.

Results: Significant associations between trauma-related complications and LOS, therapeutic paramedical products, diagnostic radiologic products, other diagnostic products, diagnostic laboratory products, therapeutic surgical procedures, other therapeutic products, and total costs (β = 5,420; 95% confidence interval, 4,912-5,929) were found. Significant associations between institutional-related complications and LOS, therapeutic paramedical products, diagnostic radiologic products, therapeutic surgical procedures, and other therapeutic products were found. Total costs (β = 170; 95% confidence interval, -760 to 1,099) showed a nonsignificant association with institutional-related complications.

Conclusion: Complications increase hospital costs, and even a small reduction in the number of complications will result in a substantial hospital cost savings and a reduction in the emotional and physical burdens of patients.

MeSH terms

  • Analysis of Variance
  • Chi-Square Distribution
  • Diagnosis-Related Groups
  • Female
  • Glasgow Coma Scale
  • Hospital Costs*
  • Humans
  • Injury Severity Score
  • Length of Stay / statistics & numerical data
  • Linear Models
  • Male
  • Middle Aged
  • Patient Safety
  • Postoperative Complications / economics*
  • Registries
  • Statistics, Nonparametric
  • Trauma Centers / economics*