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Charges associated with preventable trauma transfers after application of pediatric brain injury guidelines (kBIG)
Anastasia M Kahan1, Annika B Kay2, Sommer L Glasgow1
1University of Utah, Department of Surgery, Division of Pediatric Surgery, Salt Lake City, UT, USA.
Insights
The brain injury guidelines for kids (kBIG) can reduce healthcare costs for pediatric traumatic brain injuries (TBI) by standardizing care and preventing unnecessary transfers and interventions for low-risk patients.
Area of Science:
- Pediatric Traumatology
- Healthcare Economics
- Neurology
Background:
- Preventable pediatric trauma transfers incur significant economic burdens on healthcare systems.
- The brain injury guidelines for kids (kBIG) aim to standardize care for children with traumatic brain injuries (TBI), reducing unnecessary transfers and interventions.
- This study evaluates the economic impact of kBIG on hospital and transfer charges for low-risk pediatric TBI patients.
Purpose of the Study:
- To examine the impact of kBIG implementation on hospital and transfer charges for low-risk pediatric TBI patients.
- To assess resource utilization, including repeat head CTs and neurosurgical consultations, in relation to kBIG scores.
- To quantify the financial burden associated with these transfers.
Main Methods:
- Retrospective cohort study of pediatric blunt trauma patients with TBI (2018-2024) at a level 1 pediatric trauma center.
- Application of kBIG to identify low-risk patients (kBIG 0 and 1, AIS other body area ≤1).
- Analysis of hospital and transfer charges, repeat head CTs, and neurosurgical consultations.
Main Results:
- A total of 407 patients with kBIG 0 or 1 were transferred, accounting for approximately $10.7 million in hospital and transfer charges over 6 years.
- Repeat head CTs were performed in 12-18% of patients, and neurosurgical consultations in 44-67%.
- Aircraft transport charges were approximately $2.2 million, while ground transport charges were around $1.7 million.
Conclusions:
- The financial burden and resource overutilization for low-risk pediatric TBI transfers are substantial.
- Implementing kBIG can help reduce these economic burdens on healthcare systems and families.
- Standardizing care with kBIG ensures patient safety while optimizing resource allocation.
Introduction:
Preventable pediatric trauma transfers impose substantial economic burdens on healthcare systems by overutilization of specialized facilities and resources. The brain injury guidelines for kids (kBIG) safely standardize care and reduce unnecessary transfer and interventions for children with traumatic brain injuries (TBI). This study examines how kBIG impacts hospital and transfer charges for low-risk pediatric TBI patients transferred to a level 1 trauma center.
Methods:
A retrospective cohort of pediatric blunt trauma patients with TBI at a level 1 pediatric trauma center from 2018 to 2024 was identified. After chart review and kBIG application, hospital and transfer charges for patients with low-risk, isolated head injuries (kBIG 0 and 1, AIS other body area ≤1) were analyzed.
Results:
Of 1894 patients, 204 kBIG 0 (11 %) and 203 kBIG 1 (11 %) were transferred. Total hospital charges were estimated $6.6 M over the 6-year study period. Among these patients, 12 % of kBIG 0 and 18 % of kBIG 1 underwent repeat head CT, while 44 % of kBIG 0 and 67 % of kBIG 1 received neurosurgical consultation. There were 11 % of kBIG 0 and 12 % of kBIG 1 who were transferred by aircraft (transfer charges ∼$2.2 M) with the remaining patients transported by ground (transfer charges ∼$1.7 M). In total, the 6-year hospital and transfer charges were approximately $10.7 M, corresponding to $1.8 M annually.
Conclusion:
The financial burden and overutilization of resources associated with pediatric low-risk TBI are significant. Implementing the kBIG to reduce these burdens on the families while maintaining patient safety.
Level Of Evidence:
III.
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