*Article* **The Nature and Cost of Readmissions after Work-Related Traumatic Spinal Injuries in New South Wales, Australia**

**Lisa N. Sharwood 1,2,\*, Holger Möller 3, Jesse T. Young 4,5,6,7, Bharat Vaikuntam 1,2, Rebecca Q. Ivers 3,8, Tim Driscoll <sup>9</sup> and James W. Middleton 1,2,10**


Received: 11 March 2019; Accepted: 23 April 2019; Published: 29 April 2019

**Abstract:** This study aimed to measure the subsequent health and health service cost burden of a cohort of workers hospitalised after sustaining work-related traumatic spinal injuries (TSI) across New South Wales, Australia. A record-linkage study (June 2013–June 2016) of hospitalised cases of work-related spinal injury (ICD10-AM code U73.0 or workers compensation) was conducted. Of the 824 individuals injured during this time, 740 had sufficient follow-up data to analyse readmissions ≤90 days post-acute hospital discharge. Individuals with TSI were predominantly male (86.2%), mean age 46.6 years. Around 8% (*n* = 61) experienced 119 unplanned readmission episodes within 28 days from discharge, over half with the primary diagnosis being for care involving rehabilitation. Other readmissions involved device complications/infections (7.5%), genitourinary or respiratory infections (10%) or mental health needs (4.3%). The mean ± SD readmission cost was \$6946 ± \$14,532 per patient. Unplanned readmissions shortly post-discharge for TSI indicate unresolved issues within acute-care, or poor support services organisation in discharge planning. This study offers evidence of unmet needs after acute TSI and can assist trauma care-coordinators' comprehensive assessments of these patients prior to discharge. Improved quantification of the ongoing personal and health service after work-related injury is a vital part of the information needed to improve recovery after major work-related trauma.

**Keywords:** work-related injuries; spinal trauma; record linkage data; cost; rehabilitation; complications; unmet needs; unplanned readmissions
