Analysis of costs for emergency care and ICU treatment in multiple trauma

Treatment costs of emergency therapy, surgery and intensive care were analysed in 20 randomly chosen, representative patients with severe multiple trauma (mean ISS 32p). For an average stay of about 22.5 days on ICU, the total costs were DM 106924.36 (about 70 000 US $). DM 39 635.88 (= 37%) were the costs for physicians and nurses; DM 67 289.08 (= 63%) were needed for materials, X-rays, laboratory investigations, drugs and blood components. The whole treatment caused daily costs of DM 4752.22 or DM 3.30/min. The first emergency diagnostic procedures and emergency therapy take a mean time of 451.9 min from admission to the beginning of the ICU treatment and by itself already generates costs of about DM 12325.99. In Germany, a new way of compensation by a diagnosis-related group was introduced in 1996. These data suggest that treatment of severe multiple trauma is very expensive and trauma care could be economically harmful for smaller hospitals. We conclude that treatment of multiply injured patients (ISS > 16 p) should be compensated for by a special daily amount of about DM 5000 (about 3500 US $) for selected trauma centres.