Traumatic Injury and Medicare Beneficiaries

We see a lot of information and analysis on chronic disease prevalence and costs in the Medicare population.  Those patients are often a focus for care improvement and spending reductions.  But traumatic injuries can be more expensive and are harder to predict.  An analysis in the Journal of the American Medical Association looks at the frequency and cost of these events in the Medicare population.  (JAMA Letter)    The analysis included data from 2008 to 2014 for the fee-for-service Medicare population and evaluated the number of hospital admissions for traumatic injury, the most common of which is falls.  Rates and costs for traumatic injury for hospitalizations and post-acute care were calculated and compared to other common reasons for admissions, such as pneumonia, heart attack or stroke.  Over 11,750,000 admissions were included.  Traumatic injury was the primary reason for the hospitalization in 5.6% of admissions, which compares to 5.9% for congestive heart failure, 4.9% for pneumonia, 2.7% for heart attack and 2.7% for stroke.  During the study period, the average annual cost to Medicare of these hospitalizations and 90 days of post-discharge care was $2.76 billion dollars, or more than those for CHF at $1.8 billion, pneumonia at $1.45 billion, stroke at 1.12 billion or heart attack at $1.11 billion.  Post-acute care was particularly costly for these patients, comprising almost half of the total spending.  This research demonstrates that falls and other traumatic injuries are common among Medicare beneficiaries and are very costly to treat.  They also very likely limit the range of activities and quality of life of older persons.  So devoting attention to fall prevention and avoidance of other traumatic injuries probably has a high value.