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27 The impact of traumatic injuries on medical expenditures in the united states: a population-based study
  1. Suliman Alghnam,
  2. Roland Thorpe,
  3. Darrell Gaskin
  1. Johns Hopkins Bloomberg School of Public Health, USA


Statement of purpose Every year, as many as 31 million Americans sustain traumatic injuries leaving survivors with risks of disabilities and health settings with staggering medical costs. Little is known on the societal burden of injuries in terms of medical expenditures associated with traumatic injuries. Therefore, we utilised a nationally representative sample to evaluate the association between traumatic injuries and total health expenditures among U.S. non-institutionalised individuals.

Methods This longitudinal study used the Medical Expenditure Panel Survey (MEPS), which follows participants for two years (2007–2008). Injured individuals were selected if only reported a traumatic injury in the second year while controls were individuals without any injury. The independent variable was any self-reported injury affecting health status. Health expenditures included insurance payments as well as out-of-pocket costs. Because total expenditures were available for each year, we used the difference as the dependent variable. In addition to bivariate analyses, we constructed a modified two-part model and difference-in-difference analytic approach to investigate the association between traumatic injuries and medical expenditures. Model covariates included age, gender, education, smoking status, self-reported physical health and hypertension.

Results Of the 8,902 individuals in this sample, 923 (10.3%) reported traumatic injuries. Injured individuals were more likely to be smokers, hypertensive and reported lower levels of physical health. In multivariate analysis, reporting traumatic injuries was associated with $1420.5 ($907.5-$1933.5) increase in the average of medical expenditures adjusting for covariates.

Conclusions Traumatic injuries pose a substantial burden on medical expenditures. It is noteworthy to acknowledge that these findings are underestimates as they are limited to adults non-institutionalised population. These results lend support to prevention advocacy efforts aimed at highlighting the financial losses due to traumatic injuries.

Significance and contributions This is the first study using a nationally representative sample to assess the financial burden of traumatic injuries among U.S. adults.

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