How does a diagnosis of PTSD add to resource utilization in Florida emergency rooms?

Abstract

Abstract The objective of this analysis was to determine the added patient care time and cost associated with an incidental diagnosis of Post-Traumatic Stress Disorder (PTSD) in Florida emergency departments (ED) in Florida, United State of America. The analysis used the all-inclusive ED data from the Florida Agency for Health Care Administration, which reports patient demographic characteristics, diagnoses, location, and disposition. Facility characteristics were compiled from the Hospital Financial dataset published by the same agency. The latter data set allowed calculation of a cost-to-charge ratio for each facility to derive an estimate of the patient care cost. ED patient cases with PTSD (n = 83,346) were matched to controls using an exact neighbor algorithm based on the principal reason for the ED visit, age, gender, race, ethnicity, insurance status and type, and geographic region. In addition to the variables used for matching controls to cases, the analysis used multiple variable regression to control for additional variation based on facility characteristics and physiologic condition. Finally, the model included county fixed effects to the model to further account for the influence of facility and geographic factors. The results show that patients with PTSD spent significantly more time on average in the ED (X minutes). However, patient care facility costs did not change significantly compared to non-PTSD patients. Visit time and costs differed significantly based on demographic characteristics, insurance type and status, preexisting comorbidities, and hospital type. While direct ED related costs do not rise with a PTSD diagnosis, longer visit times imply increased resource use.