Research Reports - Burden of USA hospital charges for traumatic brain injury

Brain Inj. 2017;31(1):24-31. doi: 10.1080/02699052.2016.1217351. Epub 2016 Nov
10.

Marin JR(1), Weaver MD(2), Mannix RC(3).

OBJECTIVES: This study sought to estimate charges associated with USA hospital
visits for traumatic brain injury (TBI), compare charges from 2006-2010 and
evaluate factors associated with higher charges.
METHODS: The Nationwide Emergency Department Sample database, 2006-2010, was used
to estimate charges for emergency department visits and inpatient hospital stays
associated with TBI and trends in charges over time were compared. Multivariable
linear regression was used to evaluate factors associated with visit charges.
RESULTS: In 2010, there were $21.4 billion (95% confidence interval (CI) =
$17.7-$25.2 billion) in charges for TBI-related admissions, an increase of 22%
from 2006. Charges for ED visits resulting in discharge or transfer were $8.2
billion (95% CI = $7.4-$8.9 billion), an increase of 94% from 2006. The
proportion of charges for TBI-related visits was disproportionately higher than
the proportion of visits for TBI across all years of the study (p < 0.001).
Patient age and gender, West region, trauma centre status, non-paediatric
hospital designation, metropolitan location and hospital ownership were
independently associated with higher charges.
CONCLUSIONS: There was a substantial charge burden from TBI-related hospital
visits and charges increased disproportionately to visit volume. There are
patient and hospital factors independently associated with higher charges. These
findings, as well as methods to reduce the charge burden and charge disparities,
deserve further study. 

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