Cost prediction following traumatic brain injury: model development and validation

J Neurol Neurosurg Psychiatry. 2016 Feb;87(2):173-80. doi: 10.1136/jnnp-2014-309479. Epub 2015 Feb 18.

Abstract

Objective: The ability to predict costs following a traumatic brain injury (TBI) would assist in planning treatment and support services by healthcare providers, insurers and other agencies. The objective of the current study was to develop predictive models of hospital, medical, paramedical, and long-term care (LTC) costs for the first 10 years following a TBI.

Methods: The sample comprised 798 participants with TBI, the majority of whom were male and aged between 15 and 34 at time of injury. Costing information was obtained for hospital, medical, paramedical, and LTC costs up to 10 years postinjury. Demographic and injury-severity variables were collected at the time of admission to the rehabilitation hospital.

Results: Duration of PTA was the most important single predictor for each cost type. The final models predicted 44% of hospital costs, 26% of medical costs, 23% of paramedical costs, and 34% of LTC costs. Greater costs were incurred, depending on cost type, for individuals with longer PTA duration, obtaining a limb or chest injury, a lower GCS score, older age at injury, not being married or defacto prior to injury, living in metropolitan areas, and those reporting premorbid excessive or problem alcohol use.

Conclusions: This study has provided a comprehensive analysis of factors predicting various types of costs following TBI, with the combination of injury-related and demographic variables predicting 23-44% of costs. PTA duration was the strongest predictor across all cost categories. These factors may be used for the planning and case management of individuals following TBI.

Keywords: CLINICAL NEUROLOGY; HEAD INJURY; REHABILITATION.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Allied Health Personnel / economics
  • Amnesia / economics
  • Amnesia / etiology
  • Amnesia / therapy
  • Brain Injuries / economics*
  • Brain Injuries / rehabilitation
  • Brain Injuries / therapy
  • Costs and Cost Analysis
  • Disability Evaluation
  • Extremities / injuries
  • Glasgow Coma Scale
  • Health Care Costs
  • Hospital Costs
  • Hospitalization / economics
  • Humans
  • Long-Term Care / economics
  • Male
  • Middle Aged
  • Models, Economic
  • Reproducibility of Results
  • Socioeconomic Factors
  • Thoracic Injuries / economics
  • Thoracic Injuries / rehabilitation
  • Thoracic Injuries / therapy
  • Young Adult