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The Effect of Written and Video Discharge Instructions After Mild Traumatic Brain Injury on Healthcare Costs and
Amber E Hoek1, A J L M Geraerds, Pleunie P M Rood
1Departments of Emergency Medicine (Drs Hoek, Rood, Joosten, and Haagsma), Public Health (Drs Geraerds, van Beeck, Burdorf, Haagsma and Polinder), Neurology (Drs Dippel), and Internal Medicine (Dr Schuit), Erasmus Medical Center, Rotterdam, the Netherlands; Department of Emergency Medicine, Franciscus Gasthuis, Rotterdam, the Netherlands (Dr van den Hengel); Department of Emergency Medicine, Dijklanderziekenhuis, Hoorn, the Netherlands (Dr Dijkstra); Department of Emergency Medicine, Haaglanden Medical Center, the Hague, the Netherlands (Dr Papathanasiou); Department of Emergency Medicine, Reinier de Graaf, Delft, the Netherlands (Dr van Rijssel); and Department of Emergency Medicine, Admiraal de Ruyter Hospital, Goesthe Netherlands (Dr van den Hamer).
Objective:
To compare healthcare and productivity costs between patients with mild traumatic brain injury (mTBI) who received verbal discharge instructions only and patients who received an additional flyer with or without video instructions.
Setting:
Emergency departments (EDs) of 6 hospitals in the Netherlands.
Participants:
In total, 1155 adult patients with mTBI (384 with verbal instructions; 771 with additional flyer with or without video instructions) were included.
Design:
Cost study with comparison between usual care and intervention.
Methods:
Medical and productivity costs up to 3 months after presentation at the ED were compared between mTBI patients with usual care and mTBI patients who received the intervention.
Results:
Mean medical costs per mTBI patient were slightly higher for the verbal instructions-only cohort (€337 vs €315), whereas mean productivity costs were significantly higher for the flyer/video cohort (€1625 vs €899). Higher productivity costs were associated with higher working age, injury severity, and postconcussion symptoms.
Conclusion:
This study showed that the implementation of flyer (and video) discharge instructions for patients with mTBI who present at the ED increased reports of postconcussion symptoms and reduced medical costs, whereas productivity costs were found to be higher for the working population in the first 3 months after the sustained head injury.
