Citation

Van Deynse H, Van Belleghem G, Hubloue I, Lauwaert D, Moens M, Pien K, Devos S, Putman K. J. Head Trauma Rehabil. 2019; ePub(ePub): ePub.

Affiliation

Interuniversity Centre of Health Economic Research, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium (Mss Van Deynse, Van Belleghem, and Devos and Prof Putman); Emergency and Disaster Medicine, Department Emergency Medicine, Universitair Ziekenhuis Brussel, Brussels, Belgium (Prof Hubloue and Mr Lauwaert); Departments of Neurosurgery and Radiology (Prof Moens), Universitair Ziekenhuis Brussel, Brussels, Belgium; and Medical Registration, Universitair Ziekenhuis Brussel, Brussels, Belgium (Dr Pien).

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000522

PMID

31479077

Abstract

AIM: This study aims to determine the incremental cost of acute hospitalization for traumatic brain injury (TBI) compared with matched controls. A second purpose is to identify the factors contributing to this hospital costs.

METHODOLOGY: Analyses were performed on administrative data for injured patients, hospitalized in Belgium between 2009 and 2011 following a road traffic accident. Cases were matched to a control with similar injuries but without TBI. The incremental hospitalization cost of TBI and the factors contributing to the hospital costs were determined using multivariable regression modeling with gamma distribution and log link.

RESULTS: A descriptive comparison of cases and controls shows clear differences in healthcare utilization and costs. The presence of a TBI increases the cost by a factor between 1.66 (95% confidence interval: 1.52-1.82) and 2.08 (95% confidence interval: 1.72-2.51). Regarding healthcare utilization, the most important determinants of hospital costs are surgical complexity, use of magnetic resonance imaging, intensive care unit admission, and mechanical ventilation.

DISCUSSION: To our knowledge, this is the first matched-control study calculating the incremental hospitalization cost of TBI. The insights provided by this study are relevant in the context of prospective payments and can be an incentive for investments in prevention policies and extramural care.

Language: en