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Health Care Costs 1 Year After Pediatric Traumatic Brain Injury
Janessa M Graves1, Frederick P Rivara1, Monica S Vavilala1
1All of the authors are with the Harborview Injury and Research Center (HIPRC), Seattle, WA. Janessa M. Graves is also with the College of Nursing, Washington State University Spokane. Frederick P. Rivara is also with the Departments of Epidemiology and Pediatrics, University of Washington, Seattle. Monica S. Vavilala is also with the Departments of Pediatrics and Anesthesiology & Pain Medicine, University of Washington.
Insights
Pediatric traumatic brain injury (TBI) healthcare costs differ by severity. While severe TBI is more costly per individual, mild TBI incurs higher population-level costs due to its high prevalence.
Area of Science:
- Pediatric Traumatology
- Health Economics
- Neuroscience
Background:
- Traumatic brain injury (TBI) is a significant cause of morbidity in children.
- Understanding the economic burden of pediatric TBI is crucial for resource allocation and healthcare planning.
Purpose of the Study:
- To estimate and compare total healthcare costs for pediatric TBI across mild, moderate, and severe injury levels.
- To analyze both individual and population-level cost differences based on TBI severity.
Main Methods:
- Utilized MarketScan Commercial Claims and Encounters data from 2007-2010.
- Analyzed quarterly healthcare costs for pediatric patients (<18 years) up to one year post-TBI.
- Employed generalized linear models to compare costs across TBI severity groups.
Main Results:
- Mild TBI represented 96.6% of cases; moderate and severe TBI each accounted for approximately 1.7%.
- Individual healthcare costs were significantly higher for moderate and severe TBI compared to mild TBI in the year post-injury.
- Population-level costs for moderate and severe TBI were substantially lower than for mild TBI (88% and 75% less, respectively).
Conclusions:
- Moderate and severe pediatric TBI cases incur higher individual healthcare costs.
- Despite lower individual costs, the high incidence of mild TBI results in a greater overall population-level economic burden.
Objectives:
This study sought to estimate total health care costs for mild, moderate, and severe pediatric traumatic brain injury (TBI) and to compare individual- and population-level costs across levels of TBI severity.
Methods:
Using 2007 to 2010 MarketScan Commercial Claims and Encounters data, we estimated total quarterly health care costs 1 year after TBI among enrollees (aged < 18 years). We compared costs across levels of TBI severity using generalized linear models.
Results:
Mild TBI accounted for 96.6% of the 319 103 enrollees with TBI; moderate and severe TBI accounted for 1.7% and 1.6%, respectively. Adjusted individual health care costs for moderate and severe TBI were significantly higher than mild TBI in the year after injury (P < .01). At the population level, moderate and severe TBI costs were 88% and 75% less than mild TBI, respectively.
Conclusions:
Individually, moderate and severe TBI initially generated costs that were markedly higher than those of mild TBI. At the population level, costs following mild TBI far exceeded those of more severe cases, a result of the extremely high population burden of mild TBI.
