Analysis of Cost and Patient Charges at a Regional Burn Center

Abstract

Burn injuries present significant public health and economic challenges in the United States. This study aimed to evaluate the key drivers of burn care costs by assessing relative changes in variable direct costs (VDC). A retrospective review of burn patients treated between 2022 and 2023 was conducted using cost and clinical data from hospital financial records. Patient demographics and clinical variables, including age, total body surface area, length of hospital stay, number of days on a ventilator, number of procedures, number of complications, number of comorbidities, and presence of inhalation injury, were analyzed. Univariate and multivariate quantile regression analyses were performed at the 25th, 50th, and 75th percentiles of VDC to examine how clinical factors influence cost variation across the cost distribution.

The median age of patients was 39 years, with 66.2% being male. The median total body surface area affected was 3.7 percent, and the median length of hospital stay was 5 days. Length of stay and number of procedures were consistent predictors of increased VDC across all cost percentiles, demonstrating proportional increases in cost with greater resource utilization. At higher cost percentiles, prolonged ventilator use of four or more days demonstrated amplified effects on VDC, while procedural burden remained the strongest independent driver of increased costs after adjustment.

The primary drivers of increased VDC included length of hospital stay, number of procedures, ventilator use, and overall clinical severity, particularly among high-cost patients. Targeted strategies aimed at reducing hospital length of stay and optimizing procedural utilization may help mitigate variable direct costs. Evaluating cost drivers across the VDC distribution provides critical insight for improving cost prediction, guiding resource allocation, and maintaining high-quality burn care.