Cost containment efforts often focus on types of patients or conditions that are most expensive, not surprisingly. For example, integrated Medicare-Medicaid health plan demonstrations are one potential solution to control costs for dual eligibles, who are expected to account for 39 percent of Medicaid spending and 31 percent of Medicare spending – about $350 billion in total – in fiscal year 2013. Other efforts work to reduce hospital readmissions – a growing concern not only for Medicare and Medicaid but for private health plans as well.

Health Spending on Trauma-Related Disorders:

The Agency for Healthcare Research and Quality (AHRQ) identifies trauma-related disorders as another major source of health costs and spending in one of its helpful statistical briefs. Trauma-related disorders are what most people might call an accident that sends you to the hospital: broken bones, sprains, and other injuries.

Although most people associate injuries with emergency rooms, the brief found that almost two-thirds of trauma-related spending came from inpatient hospitals and office-based medical providers, typically physicians. Emergency room and outpatient hospital care accounted for 15 percent and 14 percent of spending, respectively. The brief drew data from the AHRQ’s Medical Expenditure Panel Survey (MEPS).

Spending on all trauma-related conditions reached $80.8 billion in 2009.  The 5 most costly trauma-related disorders accounted for $58.6 billion in expenditures or 72.5 percent of the trauma total . Medical expenditures related to sprains and strains totaled $17.9 billion in 2009, while other injuries due to external causes ranked second with $16.3 billion. Fractures of the lower and upper limbs totaled $12.0 billion and $7.0 billion, respectively. Other fractures accounted for $5.4 billion in medical expenses.

In 2009, 12.6 percent of persons residing in the Midwest received treatment for trauma-related disorders.  People in other regions of the country had lower rates of treatment for trauma-related disorders – the Northeast at 10.6 percent, the South at 10.4 percent, and the West at 10.9 percent. Compared to individuals living in an MSA, persons living in non-MSA areas were more likely to receive of treatment for trauma-related disorders (10.7 versus 12.7 percent).

Other findings from the statistical brief include:

  • Trauma-related disorders, as a group, were among the top five conditions for health care spending in 2009.
  • Cases cost an average of $2,426 per person among those who had to pay anything.
  • The elderly, people ages 65 and older, were most likely to be treated for trauma-related disorders.
  • Non-hispanic white patients made up the largest group of people treated for those disorders, at 12.9 percent.
  • High- and low-income people accounted for similar proportions of trauma-related care. People earning above 400 percent of the federal poverty level made up the largest share of cases, at 12.1 percent.