Research Reports - Trend and geographic analysis for traumatic brain injury mortality and cost

J Neurotrauma. 2013 May 5

Hu J, Ugiliweneza B, Meyer K, Lad S, Boakye M

The objective of the current research was to examine the current epidemiology of
traumatic brain injury (TBI); to determine the effects of geographic region,
co-morbidities, year of injury, injury severity and demographics on hospital
costs, length of stay (LOS), and mortality. All subjects were drawn from the
Thomas Reuters Marketscan database. Statistical methods used included descriptive
analysis, bivariate analysis, logistic regression, and the Geographic Information
System (GIS) software, ArcMap. We studied 76,313 TBI patients from 2004 to 2009
(52,721 with commercial insurance and 23,592 with Medicare) from the Marketscan
database. As age increased, mortality rate and median LOS increased. The median
hospital costs for adults were the highest ($13,000 for age 18-64) compared to
children ($8,000 for age 0-14) and elderly people ($9,000 for age≥65). The
mortality rate for the elderly population has decreased slightly (11.1% in 2004
to 9.9% in 2009 for male; and 7.0% to 6.9% for female), however their hospital
costs have increased significantly ($6,899 in 2004 to $11,567 in 2009 for males;
$6,784 to $9,782 for females). Concerning the impact of geography, the western
United States (e.g., Washington and California) had lower mortality rates and
higher median costs while the south-east US had the highest mortality and mixed
median costs. Both overall mortality and median LOS have remained relatively
stable over the years. However, hospital cost has increased for the elderly
population even after accounting for the inflation. There is significant
geographic variation for both mortality and hospital costs. Keywords: traumatic
brain injury, mortality rate, length of stay, hospital cost.

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