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Hospital costs associated with post-traumatic stress disorder in somatic patients: a retrospective study


  • Rieka von der Warth

    (Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg)

  • Philip Hehn

    (Faculty of Medicine and Medical Center – University of Freiburg)

  • Jan Wolff

    (Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg)

  • Klaus Kaier

    (Faculty of Medicine and Medical Center – University of Freiburg)


Background Post-traumatic stress disorder is likely to affect clinical courses in the somatic hospital ward when appearing as comorbidity. Thus, this study aimed to assess the costs associated with comorbid post-traumatic stress disorder in a somatic hospital and to analyze if reimbursement appropriately compensated additional costs. Methods The study used data from a German university hospital between 2011 and 2014, analyzing 198,819 inpatient episodes. Inpatient’s episodes were included for analysis if they had a somatic primary diagnosis and a secondary diagnosis of post-traumatic stress disorder. Costs were calculated based on resource use and compared to reimbursement. Analyses were adjusted for sex, age and somatic comorbidities. Results N = 219 Inpatient’s episode were found with primary somatic disorder and a comorbid post-traumatic stress disorder. Inpatients episodes with comorbid post-traumatic stress disorder were compared to 34,229 control episodes, which were hospitalized with the same main diagnosis. Post-traumatic stress disorder was associated with additional hospital costs of €2311 [95%CI €1268 - €3355], while reimbursement rose by €1387 [€563 - €2212]. Results indicate that extra costs associated with post-traumatic stress disorder are not fully reimbursed. Male patients showed higher hospital costs associated with post-traumatic stress disorder. On average, post-traumatic stress disorder was associated with an extra length of stay of 3.4 days [2.1–4.6 days]. Conclusion Costs associated with post-traumatic stress disorder were substantial and exceeded reimbursement, indicating an inadequate reimbursement for somatic patients with comorbid post-traumatic stress disorder.

Suggested Citation

  • Rieka von der Warth & Philip Hehn & Jan Wolff & Klaus Kaier, 2020. "Hospital costs associated with post-traumatic stress disorder in somatic patients: a retrospective study," Health Economics Review, Springer, vol. 10(1), pages 1-8, December.
  • Handle: RePEc:spr:hecrev:v:10:y:2020:i:1:d:10.1186_s13561-020-00281-0
    DOI: 10.1186/s13561-020-00281-0

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    References listed on IDEAS

    1. Ament, Andre & Evers, Silvia, 1993. "Cost of illness studies in health care: a comparison of two cases," Health Policy, Elsevier, vol. 26(1), pages 29-42, November.
    2. Luc Jansen & Maarten van Schijndel & Jeroen van Waarde & Jan van Busschbach, 2018. "Health-economic outcomes in hospital patients with medical-psychiatric comorbidity: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 13(3), pages 1-19, March.
    3. Matthias Vogl, 2012. "Assessing DRG cost accounting with respect to resource allocation and tariff calculation: the case of Germany," Health Economics Review, Springer, vol. 2(1), pages 1-12, December.
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    Blog mentions

    As found by, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 10th August 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-08-10 11:00:11

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