Behavioral, sociodemographic, and clinical factors associated with hospital costs following road traffic injuries in Colombia.

BACKGROUND: Road traffic injuries are a major public health and economic burden, particularly in low- and middle-income countries, where increasing motorization and limited trauma system capacity contribute to healthcare expenditures. Evidence on factors associated with hospital costs in Latin America remains limited. OBJECTIVE: To evaluate sociodemographic, accident-related, and clinical complexity factors associated with hospital costs among patients with traffic-related injuries treated at a Colombian referral hospital. METHODS: A retrospective cohort study included patients treated for road traffic injuries between 2016 and 2025 at a high-complexity referral center in Colombia. Hospital costs were expressed in Colombian pesos (COP). Multivariable linear regression using logarithmically transformed costs was performed. RESULTS: A total of 13,899 patients were included. Median age was 32 years (IQR 25-43), and 64.0% were male. Motorcycles were involved in 87.1% of accidents. Median hospital cost was COP 431,300 (IQR 190,071-1,524,400). Surgical intervention was associated with the greatest increase in costs (1,502.6%), followed by ICU admission (1,063.2%) and each additional hospital day (6.8%). Early-morning accidents were associated with 46.8% higher costs, while nighttime crashes showed a 19.3% increase. Male sex and selected occupational categories were also associated with higher costs. After adjustment for clinical complexity markers, most geographic differences were attenuated. CONCLUSION: Hospital costs following road traffic injuries were mainly associated with clinical complexity markers, particularly surgery, ICU admission, and hospital length of stay. Early-morning crashes and selected sociodemographic factors were also associated with increased costs.