Hospitals with higher resource use did not have better clinical outcomes. We observed significant inter-hospital variations in resource use for injured older patients. Higher hospital resource use was associated with higher incidence of complications for trauma (Pearson correlation coefficient = 0.5, 95% CI = 0.3-0.7) and fragility fractures (r = 0.5, 95% CI = 0.3-0.7) and with higher mortality for fragility fractures (r = 0.4, 95% CI = 0.2-0.6). Risk-adjusted resource use increased with age, and the number of comorbidities, and varied with discharge destination (P < 0.001). Risk-adjusted resource use varied significantly across trauma centres, more for older patients with fragility fractures (intra-class correlation coefficients = 0.093, 95% CI ) than with trauma (ICC = 0.047, 95% CI = 0.035-0.051). We conducted separate subgroup analyses for patients with trauma and fragility fractures. Resource use was estimated using activity-based costing and modelled with multilevel linear models. We conducted a multicenter retrospective cohort study of injured older patients (≥65 years) admitted to any trauma centres in the province of Quebec (2013-2016, N = 33,184). Secondary objectives were to identify the determinants of resource use and evaluate its association with clinical outcomes. Our primary objective was to evaluate inter-hospital variation in the risk-adjusted resource use for injured older patients. Yet, we know little about hospital resource use for injured older patients. For countries with ageing populations, admissions of injured older patients are increasing exponentially.

Injuries represent one of the leading causes of preventable morbidity and mortality. Hospitals with low risk-adjusted mortality rates have adjusted mortality rates that are 34% lower while spending nearly 22% less compared with average-quality hospitals. In this study based on the Healthcare Cost and Utilization Project Nationwide Inpatient Sample, the care of injured patients is less expensive in hospitals with lower risk-adjusted mortality rates. The cost of treating patients in average- and high-mortality trauma centers was similar. The relative cost of patients treated in high-quality hospitals was 0.78 (95% confidence interval: 0.64, 0.95) compared with average-quality hospitals.

Patients treated in hospitals with low risk-adjusted mortality rates had significantly lower costs than those treated in average-quality hospitals. Generalized linear models were used to explore the association between hospital cost and in-hospital mortality, controlling for hospital and patient factors as follows: injury diagnoses, age, gender, mechanism of injury, comorbidities, teaching status, hospital ownership, geographic region, and hospital wages. Using data from the Healthcare Cost and Utilization Projects Nationwide Inpatient Sample, we performed a retrospective observational study of 67,124 trauma patients admitted to 73 trauma centers. To examine the association between trauma center quality and costs.Ĭurrent efforts to reduce health care costs and improve health care quality require a better understanding of the relationship between cost and quality.

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