Related Experiment Video
Updated: Mar 13, 2026
A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
Published on: February 7, 2025
Direct medical charges of pediatric traumatic brain injury in multiple clinical settings
Christy L Collins1, Keith Owen Yeates2,3, Thomas L Pommering4,5
1Center for Injury Research and Policy, Nationwide Children's Hospital, Columbus, OH, USA.
Insights
Pediatric traumatic brain injuries (TBIs) incur significant medical costs across all care settings, not just emergency departments. Understanding the full spectrum of TBI charges is crucial for public health burden assessment.
Area of Science:
- Pediatric Traumatology
- Health Economics
- Public Health
Background:
- Existing data on medical charges for pediatric traumatic brain injury (TBI) are limited to emergency department and inpatient visits, underestimating the true financial burden.
- This study aimed to comprehensively estimate the direct medical charges associated with pediatric TBIs across all clinical settings within a major US pediatric hospital.
Purpose of the Study:
- To determine the total direct medical charges for pediatric traumatic brain injuries (TBIs) across all clinical encounters.
- To analyze the distribution of these charges by clinical setting, injury diagnosis, and severity.
Main Methods:
- Retrospective analysis of pediatric patients (≤20 years) treated for TBI across all hospital clinical settings from August 2010 to July 2011.
- Identification of TBI cases using specific ICD-9-CM codes.
Main Results:
- Over 5,400 TBI-related visits resulted in $13.1 million in medical charges.
- Inpatient and emergency department visits constituted the majority of charges, but outpatient settings accounted for over 15%.
- Skull fractures and contusions/hemorrhages were the costliest diagnoses, while mild TBIs, despite being most frequent, represented a lower proportion of total charges.
Conclusions:
- Pediatric traumatic brain injuries (TBIs) are treated in diverse clinical settings, with significant cost variations based on diagnosis, severity, and location of care.
- A comprehensive evaluation across the full spectrum of clinical care is essential for accurately understanding the economic impact and public health burden of pediatric TBIs.
Background:
Data limited to emergency department and inpatient visits undoubtedly underestimate the medical charges associated with traumatic brain injury. The objective of this study was to estimate the direct medical charges of pediatric traumatic brain injuries across all clinical settings in one large, pediatric hospital in the United States.
Methods:
Traumatic brain injuries sustained by children ≤20 years of age treated across all clinical settings at one large pediatric hospital from August 1, 2010-July 31, 2011 were identified using ICD-9-CM codes 310.2, 800-801.9, 803-804.9, 850-854.16, and 959.01.
Results:
3,971 individuals ≤20 years of age were seen during 5,429 traumatic brain injury-related visits. Total medical charges for pediatric traumatic brain injury-related visits were $13,131,547. Inpatient (68.7%) and emergency department (16.1%) visits accounted for the highest proportion of TBI-related charges; however, >15% of all charges were associated with visits to clinic outpatient, urgent care, and diagnostic/therapy outpatient settings. Fracture of the vault or base of the skull (37.1%) and brain injury with contusion, laceration, or hemorrhage (27.1%) accounted for the largest proportion of total charges. Although unspecified head injuries made up almost half of all TBI-related visits (47.4%), they accounted for only 12.6% of total charges. Mild traumatic brain injuries accounted for 92.0% of all traumatic brain injury-related visits but only 44.7% of all traumatic brain injury-related charges. Mild traumatic brain injuries treated in the emergency department had a higher median total charge than those treated in urgent care (p < 0.0001) or clinic outpatient setting (p < 0.001).
Conclusions:
This study, the first to evaluate the direct medical charges of pediatric traumatic brain injury across all clinical settings at one large pediatric hospital, found that pediatric traumatic brain injuries present to a wide variety of clinical settings, and differences exist in total charges by diagnosis, severity of the injury, and clinical site/setting. Investigating traumatic brain injuries across the full spectrum of clinical care is needed for a better understanding of the true medical cost and public health burden of pediatric traumatic brain injury.
