Acute hospital costs of pediatric trauma in the United States: How much and who pays?

Ellen J. MacKenzie, John A. Morris, Gregory V. de Lissovoy, Gordon Smith, Maureen Fahey

Research output: Contribution to journalArticlepeer-review


National estimates of the numbers and expenditures associated with hospitalization due to injury among children (aged 0 to 14) were derived using data from the 1984, 1985, and 1986 National Hospital Discharge Surveys (NHDS) and the 1980 National Medical Care Utilization and Expenditures Study (NMCUES). In this report, age- and sex-specific estimates of the numbers of hospital admissions and expenditures are reported for subgroups of patients defined by external cause of the injury and by nature and severity of the injury. In 1985, over 266,00 children sustained a traumatic injury resulting in hospitalization (rate of 51 per 10,000 children). Expenditures totaled nearly $1 billion. Over 80% of the hospitalizations and two thirds of total expenditures were for minor (Maximum AIS = 1,2) trauma. Moderate (Maximum AIS = 3) and severe (Maximum AIS = 4,5) trauma accounted for 18% and 2% of admissions and 31% and 8% of expenditures, respectively. Falls ranked first in expenditures and admissions (36% of the total). Motor vehicle-related injuries accounted for 19% of trauma admissions and 24% of expenditures. Other less common causes included bicycle injuries, penetrating injuries and injuries caused by the child being hit by an object or person. An estimated 28% of the total hospital charges were paid for by public sources (15% from federal government programs, 13% from state and local programs). An additional 63% of total expenditures were paid for by private sources, with the remaining 9% considered uninsured care. This analysis suggests that the designation of pediatric trauma centers would not appreciably affect the revenues of nontrauma centers because minor and moderate injuries representing 91% of total trauma admissions and 79% of total charges would remain in the domain of the nontrauma center hospital.

Original languageEnglish (US)
Pages (from-to)970-976
Number of pages7
JournalJournal of pediatric surgery
Issue number9
StatePublished - Sep 1990


  • Pediatric trauma
  • cost

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health


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