141st APHA Annual Meeting and Exposition

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287362
Pediatric ATV injuries: Incidence and cost in the state of Pennsylvania


Sunday, November 3, 2013

Kent Strohecker, MS, Department of Orthpaedics, Geisinger Medical Center, Danville, PA
Raveesh D. Richard, MD, Department of Orthopaedics, Geisinger Medical Center, Danville, PA
Christian J. Gaffney, MD, Department of Orthopaedics, University of Utah, Salt Lake City, UT
Thomas R. Bowen, MD, Department of Orthopaedic Surgery, Geisinger Medical Center, Danville, PA
Wade R. Smith, MD, Department of Orthopaedics, MOTUS, Englewood, CO
Background: ATV (All-Terrain Vehicle) injuries are a source of significant morbidity in mortality across all age groups. Pennsylvania is second in ATV related injury and deaths with children < 16 accounting for 28% of these injuries in 2007. Despite recommendations from the American Academy of Pediatrics that children under 16 not drive ATV's, children < 12 accounted for 51% of ATV related hospital admissions. We hypothesized that these injuries carry a substantial cost. Methods: Population-based retrospective cohort design. We reviewed the costs of care of children injured during a four-wheeled ATV accident from January 1, 2007, to December 31, 2009 admitted to a level 1 trauma center in the state of Pennsylvania. Results: In this cohort of 78 patients (age 2-16) involved in ATV accidents, the cost of care varied greatly, from a few hundred dollars to over $300,000. Older patients had higher costs on average. Patients wearing helmets were drivers, or had a rollover or ejection had lower costs on average; however, none of these trends were statistically significant in this sample. The statistically significant finding was related to hospital LOS: patients involved in rollover accidents were much more likely to require a hospital stay of one day or longer (Odds Ratio 3.45, p=0.02). Additionally, patients wearing helmets were marginally less likely to require an overnight hospital admission (Odds Ratio 0.34, p=0.07). Conclusion: Interventions to increase helmet use among ATV riders and measures to improve ATV stability seem warranted.

Learning Areas:

Implementation of health education strategies, interventions and programs

Learning Objectives:
Evaluate the severity and incidence of four-wheeled ATV related pediatric injuries in the state of Pennsylvania and correlate these with a cost model genterated from admission data to a level 1 trauma center.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Clinical Research Coordinator for the Department of Orthopaedics at a level I trauma center. I currently oversee 12 funded and 42 physician initiated projects. I am currently pursuing my Master of Health Service Administration degree with an anticipated graduated date of May 31, 2014.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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