All-terrain Vehicle (ATV)-related Hospitalizations in the United States, 2004

Purpose. The objective was to estimate the prevalence of ATV injury hospitalizations in the U.S. during 2004, and to describe the demographic, clinical and cost characteristics of these injuries. Methods. Data were obtained from the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample – a stratified probability sample of 1004 community hospitals from 37 states. ATV injuries were defined by ICD-9-CM external cause of injury codes E821.0, 821.1, 821.8, and 821.9. Variables included age, gender, primary diagnoses, patient disposition, primary payer, and hospital charges. Results. 15,697 (95% CI 13,532-17,862) ATV-related hospitalizations were estimated for 2004; 81% were male. Thirty percent of the cases were under age 18 and 8% were over age 60. Passengers accounted for 21% of the hospitalizations. Eighty-four percent were routinely discharged from the hospital to home while 12% required long-term rehabilitation or home health care. Principal diagnoses included fracture of lower limb (20%, with mean hospital charges of $24,576), intracranial injury (16%, $40,382), other fractures (14%, $24,211); crushing and internal injuries (13%, $27,374), and fracture of upper limbs (12%, $20,605). Payers included private insurance (60%), Medicaid and self-pay (13% each), and Medicare (7%). Rural hospitals treated 20% of the cases and urban teaching hospitals 56%. The national crude unadjusted hospital admission rate was higher for males (9.0 per 100,000) compared to females (2.1). Conclusions. These findings indicate that there is substantial morbidity and financial burden resulting from ATV injuries. A renewed focus on ATV safety and prevention efforts is warranted.