The cost of providing health care to injured soldiers in war.

BACKGROUND As the Global War on Terror progresses, the total health cost for treating wounded soldiers continues to rise. Although some reports have estimated the total cost of soldiers' health care, no study has attempted to rigorously quantify this amount. We sought to quantify the cost of providing health care to soldiers injured while on duty in a conflict area. METHODS Retrospective study of all Canadian Forces (CF) soldiers injured in Afghanistan from February 7, 2006, to February 6, 2007. CF trauma registry was used to identify all injured Canadian soldiers and hospitalized at the military field hospital in Kandahar. Financial reports from the Canadian Forces Health Services were used to quantify the cost of providing care to these soldiers in Kandahar at Landstuhl Regional Medical Center and during evacuation back to Canada. Insurance claims paid (as of October 15, 2007) to a third-party insurer by the CF were used to quantify the charges and costs of health care in Canada. All dollar figures are in Canadian dollars. RESULTS During the 1-year period, the CF spent more than $24.3 million to provide health care to 1,245 patients at its field hospital in Kandahar. One hundred twenty-seven of these patients were injured Canadian soldiers who required admission to the field hospital. A total of 93 soldiers required evacuation to Landstuhl Regional Medical Center, and of these, 75 required further care at the Canadian civilian hospitals. The CF spent approximately $2.5 million to provide trauma care in Kandahar to its 127 injured soldiers. Caring for 93 wounded soldiers at Landstuhl Regional medical center cost approximately $2.0 million. Air evacuation costs of 75 wounded soldiers back to Canada cost $3.9 million. The CF were charged approximately $2.4 million for further care in Canada for 75 severely wounded soldiers. The estimated actual cost of this care in Canada was $1.4 million. CONCLUSIONS Estimating the financial cost to properly care for soldiers wounded on overseas duty in the conflict areas is critical for future planning and forecasting. We estimated on average, it costs approximately $20,000 to care for a wounded soldier at a field hospital who is subsequently returned to duty, $42,000 for the case of a wounded soldier treated at an out-of-theater regional referral hospital and subsequently returned to duty, and $113,000 to care for a wounded soldier who is repatriated and finally treated in Canada. Most of the costs are from establishing and staffing field hospitals in the conflict area and from evacuation costs.