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Pediatric traumatic brain injury: acute and rehabilitation costs
K M Jaffe1, T L Massagli, K M Martin
1Department of Rehabilitation Medicine, University of Washington, Seattle.
Insights
Pediatric traumatic brain injury (TBI) is costly, with severe injuries incurring over $53,000. Costs vary significantly by injury severity and cause, highlighting the need for targeted prevention and resource allocation.
Area of Science:
- Public Health
- Health Economics
- Pediatric Traumatology
Background:
- Pediatric traumatic brain injury (TBI) presents a significant public health challenge.
- The economic burden associated with pediatric TBI remains largely unquantified.
Purpose of the Study:
- To prospectively evaluate the economic costs of pediatric TBI.
- To examine the relationship between TBI costs and injury severity and etiology.
Main Methods:
- Prospective data collection on hospital charges and professional fees for 96 pediatric TBI patients.
- Analysis of costs across emergency department services, acute inpatient care, and inpatient rehabilitation.
- Correlation of costs with injury severity (Glasgow Coma Scale) and etiological factors.
Main Results:
- Median costs varied by care setting: $5,233 (overall), $11,478 (hospitalized), $230 (ED only).
- Costs differed by etiology: $15,213 (motor vehicle), $6,311 (bicycle), $792 (falls).
- Median costs by severity: $598 (mild), $12,022 (moderate), $53,332 (severe TBI).
Conclusions:
- Injury severity is a primary driver of pediatric TBI costs.
- Etiology significantly, though modestly, contributes to cost prediction.
- Rehabilitation represents a substantial cost, particularly for severe injuries (45% of total cost).
Abstract:
Pediatric traumatic brain injury constitutes an enormous public health problem, but little is known about the economic costs of such injury. Using charges as a proxy for cost, we prospectively collected data on initial hospital charges and professional fees for emergency department services, acute inpatient care, and acute inpatient rehabilitation for 96 patients with mild, moderate, and severe traumatic brain injuries. We also examined the relationship between these costs and injury severity and etiology. Acute care and rehabilitation median costs were $5,233 per child, $11,478 for hospitalized children, and $230 for those only seen in the emergency department. Median costs for injuries due to motor vehicles, bicycles, and falls were $15,213, $6,311, and $792, respectively. Using Glasgow Coma Scale criteria, median cost of mild, moderate, and severe traumatic brain injuries were $598, $12,022, and $53,332, respectively. Injury etiology added modestly but significantly to the prediction of cost over and above that predicted by injury severity alone. Rehabilitation costs accounted for 37% of the total for all children, but 45% of those with the most severe injuries.