The Cost of Complications In Graft Repair For Extremity Arterial Trauma: Real-World Evidence From Linked Hospital Chargemaster And Insurance Claims Databases
Author(s)
Fulton Velez, MBA, MS, MD1, Elizabeth Brouwer, MPH, PhD2, Junwei Tan, BS2;
1Humacyte Global, Inc., Durham, NC, USA, 2Curta, Seattle, WA, USA
1Humacyte Global, Inc., Durham, NC, USA, 2Curta, Seattle, WA, USA
OBJECTIVES: To estimate hospital charges and corresponding payer costs during the initial hospitalization of patients with extremity arterial trauma who underwent graft repair.
METHODS: Patients aged ≥18 years with ≥1 claim for extremity arterial trauma with graft repair between 01/01/2018 and 03/31/2023 were identified in linked PINC AI Healthcare (hospital chargemaster) and Inovalon (health insurance claims) databases. Total hospital charges were presented for each unique hospital encounter, while total payer costs summed all patient claims between admission and discharge. Total charges and costs were inflated to USD 2024 and analyzed using a two-part model: logit for any costs, and a gamma family with a log link for costs >$0. Models controlled for age, gender, injury location, graft type, payer type, trauma center level, region, and common complications (orthopedic fracture, vein/nerve injury, infection, amputation, rhabdomyolysis, fasciotomy, thrombectomy, aneurysm).
RESULTS: A total of 964 patients were included, with hospital charge data for 707 patients and payer costs data for 465 patients. Mean hospital charges were $311,378 (SD: $383,044) per hospitalization and mean payer costs were $74,695 (SD: $122,672). Average charge per day was $28,787 (SD: $25,567), while average cost per day was $14,113 (SD: $25,901). Infection increased charges by $639,558 (p<0.01), and costs by $84,598 (p<0.01). Amputation increased charges by $492,986 (p=0.02), and costs by $116,611 (p<0.01). Orthopedic fractures were associated with an increase of $639,558 (p<0.01) in charges, and $91,462 (p<0.01) in costs. Rhabdomyolysis increased charges by $477,304 (p<0.01), and costs by $20,256 (p=0.2). Other complications increased charges and costs but did not achieve statistical significance: fasciotomy ($302,256 in charges/$8,692 in costs), thrombectomy ($308,827/$7,194), and aneurysm ($264,874/$10,098).
CONCLUSIONS: Complications, particularly infection, amputation, and orthopedic fractures, significantly increase costs and charges during the initial hospitalization for extremity arterial trauma. These findings should be considered in economic evaluations of new technologies for arterial trauma care.
METHODS: Patients aged ≥18 years with ≥1 claim for extremity arterial trauma with graft repair between 01/01/2018 and 03/31/2023 were identified in linked PINC AI Healthcare (hospital chargemaster) and Inovalon (health insurance claims) databases. Total hospital charges were presented for each unique hospital encounter, while total payer costs summed all patient claims between admission and discharge. Total charges and costs were inflated to USD 2024 and analyzed using a two-part model: logit for any costs, and a gamma family with a log link for costs >$0. Models controlled for age, gender, injury location, graft type, payer type, trauma center level, region, and common complications (orthopedic fracture, vein/nerve injury, infection, amputation, rhabdomyolysis, fasciotomy, thrombectomy, aneurysm).
RESULTS: A total of 964 patients were included, with hospital charge data for 707 patients and payer costs data for 465 patients. Mean hospital charges were $311,378 (SD: $383,044) per hospitalization and mean payer costs were $74,695 (SD: $122,672). Average charge per day was $28,787 (SD: $25,567), while average cost per day was $14,113 (SD: $25,901). Infection increased charges by $639,558 (p<0.01), and costs by $84,598 (p<0.01). Amputation increased charges by $492,986 (p=0.02), and costs by $116,611 (p<0.01). Orthopedic fractures were associated with an increase of $639,558 (p<0.01) in charges, and $91,462 (p<0.01) in costs. Rhabdomyolysis increased charges by $477,304 (p<0.01), and costs by $20,256 (p=0.2). Other complications increased charges and costs but did not achieve statistical significance: fasciotomy ($302,256 in charges/$8,692 in costs), thrombectomy ($308,827/$7,194), and aneurysm ($264,874/$10,098).
CONCLUSIONS: Complications, particularly infection, amputation, and orthopedic fractures, significantly increase costs and charges during the initial hospitalization for extremity arterial trauma. These findings should be considered in economic evaluations of new technologies for arterial trauma care.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE456
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Injury & Trauma