Journal
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE
Volume 49, Issue 3, Pages 487-495Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/00005373-200009000-00017
Keywords
psychiatric diagnoses; posttraumatic stress disorder; cost; length of stay; trauma; injury severity
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Funding
- NICHD NIH HHS [P2C HD042849] Funding Source: Medline
- NIMH NIH HHS [1K08 MH01610, 1R01 MH44331A] Funding Source: Medline
- NATIONAL INSTITUTE OF MENTAL HEALTH [K08MH001610, R01MH044331] Funding Source: NIH RePORTER
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Background: Although psychiatric disturbances are highly prevalent among traumatically injured inpatients, few investigations have assessed the impact of these disorders on surgical length of stay (LOS) and cost. Methods: The authors identified all trauma-registry recorded psychiatric diagnoses among patients admitted to University of California Davis Medical Center between January 1993 and December 1996, Linear and logistic regressions were used to assess the unique effects of psychiatric diagnoses on inpatient LOS and cost. Results: A total of 29% of patients had one or more registry-recorded psychiatric diagnosis. Patients with alcohol abuse diagnoses demonstrated 10% to 12% decreases in LOS and cost (p < 0.01), whereas patients with stress disorders, delirium, and psychoses demonstrated 46% to 103% increases in LOS and cost (p < 0.01). Conclusion: Patients with recognized psychiatric disorders uniquely impact inpatient trauma surgery LOS and cost. Additional investigations of the processes and outcomes of care could lead to cost-effective performance improvement efforts that target the amelioration of comorbid psychiatric disorders among physically injured trauma survivors.
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