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Published on: August 16, 2019
Cost of pediatric traumatic brain injury in developing countries: a retrospective cohort study
Aisha Nasser Al Fudhaili1, Sara Salim Al Mashrafi2, Ahad Nasser Al Ghammari1
1Sultan Qaboos University Internship Office, Muscat, Sultanate of Oman.
Insights
Pediatric traumatic brain injury (TBI) poses a significant economic burden, particularly in children under 5 and those with severe injuries. Understanding these costs is crucial for implementing effective safety programs and improving patient management.
Area of Science:
- Neuroscience
- Public Health
- Health Economics
Background:
- Traumatic brain injury (TBI) is a global health issue.
- The economic impact of pediatric TBI in developing nations remains under-researched.
- This study quantifies the economic burden of pediatric TBI, differentiating by injury severity.
Purpose of the Study:
- To determine the economic burden of pediatric traumatic brain injury (TBI) in a developing country.
- To compare the costs associated with mild, moderate, and severe TBI cases.
- To identify factors influencing the total cost of pediatric TBI.
Main Methods:
- Retrospective analysis of 921 pediatric TBI cases (2015-2019) at a tertiary hospital.
- Data collection included demographics, injury details, interventions, and hospital stay duration.
- Cost data from hospital finance division were used to calculate total costs and analyze influencing factors.
Main Results:
- Pediatric TBI incurred substantial costs, with falls and motor vehicle collisions being major contributors.
- Higher costs were associated with normal radiological findings, skull fractures, and epidural hematomas.
- Severe TBI, surgical intervention, age under 5, and prolonged hospital stays significantly increased total costs (P < 0.001).
Conclusions:
- Pediatric TBI represents a considerable health and economic challenge, especially for children under 5 and those with severe injuries.
- Implementing child safety initiatives and optimizing hospital management protocols are essential.
- Further research into the economic burden of TBI in developing countries is warranted.
Introduction:
Traumatic brain injury (TBI) is a known health burden worldwide; however, no literature is available on its economic burden in developing countries, this study aims to highlight the cost of pediatric TBI and compare mild, moderate, and severe cases.
Methods:
A retrospective study was conducted in the neurosurgery department of a tertiary hospital in a developing country. Data on pediatric cases presenting with TBI from January 2015 to December 2019 was collected from electronic medical records; this included patients' demographics, neuro-vital signs, mechanism of TBI, intervention, diagnosis on imaging, investigations, medications, duration of hospital and intensive care unit stay. Costs of interventions, investigations, and hospital stay were retrieved from the hospital finance division, total costs were calculated, and analysis was done to compare the relation of age, diagnosis, mechanism of injury, and intervention to total cost.
Results:
The sample included 921 cases (M: F, 1.7:1), with 67.1% aged less than 5 years. Falls and motor vehicle collisions had the highest total costs. Cases with normal radiological findings and skull fractures constituted 35.9% and 30.2%, respectively, and consequently had the highest costs; epidural hematoma followed in highest costs. TBI severity, surgical intervention, age < 5 years old, and longer hospital stays were significantly associated with higher total costs (P < 0.001).
Conclusions:
Pediatric TBI is a health and economic burden, most notably in children less than 5 years old and those with severe injuries. Programs advocating children's safety and hospital guidelines for the diagnosis and appropriate timely management need to be implemented.
