Research Reports - Costs of care following traumatic brain injury
J Neurotrauma. 2013 Apr 9
Ponsford J, Spitz G, Cromarty F, Gifford D, Attwood D
Traumatic brain injuries (TBI) impose a significant burden on the health care
system. The aim of the current study was to explore variation in costs in a group
of rehabilitation patients following complicated mild to severe TBI in Victoria,
Australia, treated under the accident compensation system administered by the
Transport Accident Commission. Study participants included 1237 individuals with
mild-to-severe TBI recruited consecutively from a TBI rehabilitation program.
Long term care, hospital, medical, and paramedical costs were obtained 10 years
post-injury and their association with demographic and injury-related variables
examined. Significant variability in costs was evident. Long term care costs were
highest, followed by hospital, paramedical and medical costs. Duration of
post-traumatic amnesia (PTA) was a strong predictor of all costs and stronger
than Glasgow Coma Score. Longer acute hospital stay was related to higher costs.
In addition to PTA duration and GCS, other factors associated with higher of
long-term costs were having an abnormal CT scan and epilepsy early after injury.
Higher hospital and medical costs were associated with these factors, but also
with other physical injuries, lower education, pre-injury unemployment, living
outside the city, speaking English at home and in the case of medical costs,
older age and having had pre-injury psychiatric treatment. Higher paramedical
costs were associated with most of these variables, but also with being employed
prior to injury and being female. In line with the multifaceted nature of TBI,
the current findings suggest that both injury-related and demographic factors
determine costs following injury.