Health resource utilisation costs in acute patients with persistent midline cervical tenderness following road trauma

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Abstract

The costs associated with patients discharged with isolated clinician-elicited persistent midline tenderness and negative computed tomography (CT) findings have not been reported. Our aim was to determine the association of acute and post-acute patient and injury characteristics with health resource costs in such patients following road trauma. Methods In a prospective cohort study, road trauma patients presenting with isolated persistent midline cervical tenderness and negative CT, who underwent additional acute imaging with MRI, were recruited. Patients were reviewed in the outpatient spine clinic following discharge, and were followed up at 6 and 12 months post-trauma. Multivariate linear regression was used to assess the association of injury mechanism, clinical assessment, socioeconomic factors and outcome findings with health resource costs generated in the acute hospital and post-acute periods. Results There were 64 patients recruited, of whom 24 (38 ) had cervical spine injury detected on MRI. Of these, 2 patients were managed operatively, 6 were treated in cervical collars and 16 had the cervical spine cleared and were discharged. At 12 months, there were 25 patients (44 ) with residual neck pain, and 22 (39 ) with neck-related disability. The mean total cost was AUD 10,153 (SD = 10,791) and the median was 4015 (IQR: 3044?6709). Transient neurologic deficit, which fully resolved early in the emergency department, was independently associated with higher marginal mean acute costs (represented in the analysis by the ? coefficient) by 3521 (95 CI: 50?6880). Low education standard (? coefficient: 5988, 95 CI: 822?13,317), neck pain at 6 months (? coefficient: 4017, 95 CI: 426?9254) and history of transient neurologic deficit (? coefficient: 8471, 95 CI: 1766?18,334) were associated with increased post-acute costs. Conclusion In a homogeneous group of road trauma patients with non fracture-related persistent midline cervical t
Original languageEnglish
Pages (from-to)1908 - 1916
Number of pages9
JournalInjury
Volume43
Issue number11
DOIs
Publication statusPublished - 2012

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