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A Decision Tree Cost Analysis of Intracranial Bleed Detection Using a Near-Infrared Device Across Various Healthcare
Mamta Patel1, Amit Kumar Mittal1, Mohit Agrawal2
1Resource Centre, Health Technology Assessment, All India Institute of Medical Sciences (AIIMS), Jodhpur 342001, India.
Journal of Market Access & Health Policy
|June 25, 2026
Summary
Portable near-infrared spectroscopy (NIRS) offers a cost-effective solution for early traumatic brain injury (TBI) detection, especially in low-resource settings. Implementing NIRS can improve diagnosis and resource allocation for TBI patients.
Area of Science:
- Medical Technology
- Public Health
- Health Economics
Background:
- Traumatic brain injury (TBI) is a significant global health issue, often resulting from road accidents.
- Computed tomography (CT) is effective for detecting intracranial hemorrhage (ICH) but faces accessibility, radiation, and cost barriers, particularly in low- and middle-income countries.
- Portable near-infrared spectroscopy (NIRS) presents a non-invasive, point-of-care alternative for early ICH detection.
Purpose of the Study:
- To estimate the cost per detected case of intracranial hemorrhage (ICH) for patients with mild-to-moderate traumatic brain injury (TBI) using NIRS.
- To calculate the incremental cost associated with NIRS implementation across different healthcare settings.
- To conduct a budget impact analysis for assessing the financial feasibility of integrating NIRS technology.
Main Methods:
- A decision tree model was utilized from a health system perspective.
- Cost per detected case and incremental costs were calculated for NIRS in ambulances, community health centers (CHCs), and tertiary hospitals.
- A budget impact analysis was performed to evaluate the financial implications of NIRS adoption.
Main Results:
- The cost per mild-to-moderate TBI case detected by NIRS was Rs. 2177.90 in ambulances, Rs. 748.09 in CHCs, and Rs. 628.14 in tertiary hospitals.
- Incremental costs per patient were Rs. 984.15 (ambulances), Rs. 360.90 (CHCs), and Rs. 289.78 (tertiary hospitals).
- System-level implementation projected a first-year budget impact of approximately Rs. 442 crores for ambulances and Rs. 187 crores for CHCs.
Conclusions:
- NIRS technology demonstrates a feasible and cost-effective approach for early TBI diagnosis, particularly in resource-limited environments.
- Phased implementation of NIRS can optimize resource utilization and enhance diagnostic capabilities for TBI.
- The findings support the strategic integration of NIRS to improve patient outcomes in traumatic brain injury management.
