Road traffic crashes represent a substantial burden of trauma-related morbidity and mortality worldwide [1]. Motorcyclists represent one of the most affected groups, with over 10,000 motorcycle-related hospitalisations recorded annually in Australia alone [1]. Due to driver, vehicle and environmental factors, motorcyclists are disproportionately represented in transport crash data, with a risk of death 30 times greater, and a risk of injury eight times greater, than those driving other vehicles [2,3]. One of the most common injuries sustained, and a major cause of morbidity, is lower limb orthopaedic injury [4]. In Australian and international crash data, almost half of all motorcycle crash inpatients sustain a lower extremity fracture from their crash [4], [5], [6]. These patients often require operative management with potentially lengthy admissions and post-operative recovery; consequently, motorcycle crashes represent a significant financial burden to crash victims and health systems [7], [8], [9]. Data suggest that between 4% and 7% of orthopaedic trauma patients are readmitted to hospital within 30-days of their index admission [6,10,11], with up to 17% readmitted within one year [10]. This has implications for patients and health systems, in terms of inpatient management, models of care and financial and other costs [9].

Whilst the incidence of motorcycle crashes in Australia has been studied, there is comparatively little literature detailing the acute hospitalisation of these patients, or the costs of these admissions. International data from Canada and Europe suggest that acute inpatient stays after motorcycle trauma cost between US$5,475-US$9,411 per admission [7,9], however, these studies did not include readmission costs. Smaller studies examining longer-term costs found total medical costs in the 6-months after initial admission could total more than US$17,000 per patient [12]. Adequately detailing Australian data for lower limb fracture hospitilisation costs could help health systems improve care for patients, reduce readmissions and identify areas for cost reduction to improve the sustainability of healthcare.

This study aims to address this gap by: (1) describing the epidemiology of hospitalised motorcycle crash patients with pelvic or lower limb fractures admitted to Queensland hospitals over a 5-year period; (2) describing the incidence and risk factors for 30-day readmission for these patients; and (3) evaluating the cost to the public hospital system for treatment of these patients [13]. This study was undertaken in accordance with the Declaration of Helsinki and was approved by the Royal Brisbane and Women's Hospital's Human Research Ethics Committee (HREC/18/QRBW/208) [14].