Healthcare cost usage for hospitalised injuries sustained in industrial settings in the USA

Abstract

Objective: To describe characteristics and outcomes of patients hospitalised for injuries occurring in industrial settings during a 1-year period.

Methods: A retrospective analysis of hospital admissions in the USA in 2006 using the Nationwide Inpatient Sample was performed. The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9 CM) code E849.3 (industrial place and premises) was used to identify work-related injury admissions.

Results: A total of 5826 patients were hospitalised with injuries sustained in industrial settings (weighted, 28,354 patients). The mean age was 42.9 years (82% were men). They were 48% Caucasian, 19% Hispanic and 6% African-American. The majority were admitted from the Emergency Department (72%). Further the majority of admissions were discharged home (79%; 9% with home healthcare) and 10.7% were transferred to another facility. The mean length of stay was 4.5 days (range 0-109 days). Mean total charges per admission was US$32,254 (median US$18,364, 90th percentile US$66,607). Common diagnoses included: orthopaedic injuries (including amputations) to: finger/hand (20.9%), foot/ankle (8.2%), leg (10.2%) and spine (8.4%); infection (10.8%), pulmonary diagnosis (6.6%), soft tissue injuries (3.6%) and burns to <10% of the body (3.6%). Comorbidities included hypertension (17.0%) and diabetes mellitus (6.3%). Most common procedures performed included fracture reduction (17.6%), blood transfusions (3.1%) and spinal surgery (3%). A total of 194 (0.7%) patients died in the hospital.

Conclusions: Injuries in industrial settings result in significant healthcare usage, morbidity and mortality on an annual basis in the USA. These admission levels facilitate development of targeted strategies to optimise the quality and economics of care for injuries in industrial settings.