Outcomes and costs of blunt trauma in England and Wales

Table 1 Unit costs

Cost component	Unit or duration (min)	Unit cost (£)	Source and notes
Mode of arrival at hospital
Ambulance	Cost per minute	5.50	Curtis and Netten (p. 112) [16]
			Cost per minute of emergency ambulance service
Helicopter	Mean cost per patient journey	1,650	London Air Ambulance website http://www.londonsairambulance.com/
			Mean cost per mission
Hospital stay
Accident and emergency department	Mean cost per attender	278	Department of Health [17]
			Mean cost per attender across all accident and emergency Healthcare Resource Groups
General ward	Mean cost per day	281	Department of Health [17]
			Mean national average unit cost per day across all nonelective Healthcare Resource Groups
Critical care unit	Mean cost per day	1,328	Department of Health [17]
			Mean cost per day in intensive care unit/intensive therapy unit
Surgical procedures^a
Open reduction and internal fixation	126	1,597	Trauma Audit Research Network, National Institute for Health and Clinical Excellence [18]
Nail insertion	168	1,861
Wound debridement	139	1,680
Manipulation of bone	69	1,230
Screw insertion	111	1,499
External fixation	147	1,731
Evacuation of extradural haematoma/subdural haematoma	138	1,673
K-wire insertion	102	1,443
Intercranial pressure monitor	97	1,410
Craniotomy	175	1,906

^aDetails reported for the 10 most common procedures only; 103 procedures are included in the analysis. The duration and unit cost range from 10 minutes and £852 for gastroscopy to 475 minutes and £3,828 for escharatomy. The duration (min) for each procedure was computed internally using the Trauma Audit Research Network database. The unit costs were then computed by multiplying the duration by the variable cost per minute from National Institute for Health and Clinical Excellence and adding a fixed cost per procedure also taken from National Institute for Health and Clinical Excellence [18]. This method has been used in previous UK cost analyses of trauma care [19]>.

ISSN: 1364-8535