The incidence and degree to which patients injured by motor vehicle crashes (MVCs) and penetrating wounds (PW) remain in the hospital beyond the DRG mean length of stay (LOS) are compared. During a six month period, 1487 consecutive patients admitted to 8 hospitals (including 3 trauma centers) were studied. Patients aged < 13, staying < 48 hours, with major burns or distal fractures were excluded. Twenty percent of injuries were penetrating;​ 29% were MVC injuries;​ and 51% were blunt injuries from other causes. Patients injured in MVCs and with penetrating injuries were compared with respect to mean LOS, incidence of DRG outliers, number of hospital days beyond the DRG mean LOS and demographic variables.

Patients injured in MVC's had a greater proportion of DRG LOS outliers and higher mean number of DRG excess days than did patients with penetrating wounds (p < 0.01 for both). Injuries were disbursed among relatively more DRGs for MVCs patients. The DRG scheme may lack sufficient attention to factors more likely to affect MVC patients, such as multiplicity of injuries, incidence of CNS injuries, and older age. In structuring more appropriate reimbursement for trauma care, special attention must be paid to patients injured in MVCs.