PIT2 Acute Care Costs of Pediatric Sports-Related Head Injuries in Australia: The Australasian Paediatric Head Injury Study (APHIRST)

Abstract

Sports activities are a common cause of traumatic brain injury (TBI) in children. Annual costs of hospitalization for all sports-related injuries for children aged ≤16 years in Australia are approximately AU $40 million. We aimed to compare emergency department (ED) and hospital acute care costs for children with head injuries due to sports activities in Australia. This was a cost analysis of a multi-center prospective observational study of 17,841 children <18 years-old with head trauma. Sports-related head injuries were identified using the ICD-10-AM activity codes U50-U71. We stratified participants into two age-groups (younger: 5 to <12 years) and (older: 12 to <18 years). Taking a public-sector healthcare perspective, we applied costs from a single pediatric site to patient-level data and estimated acute care costs for ED visits and hospital admissions. All costs were inflated to 2018 Australian dollars ($). Total acute care costs for 2,812 children with sports-related head injuries were $2.7 million, and the average cost per episode was $954 (95%CI $832-$1,084). The younger age-group accounted for 44% of children and 38% of acute care costs ($1.0 million). Bicycle riding was the most common mechanism of head injury in the younger age-group and had the highest total acute care costs ($355,000), with an average cost per episode of $1,522 (95%CI $1,036-$2,008). Rugby was the most common head injury mechanism in older children, accounting for 10% of the cohort, 7.2% of total acute care costs ($192,000), and had an average cost of $682 (95% CI $564-$801). In the older age-group, skateboarding had the highest acute care costs ($430,000), with the average cost per episode of $3,797 (95% CI $1,082-$6,512). Sports-related trauma accounts for approximately 15% of pediatric head injuries and associated acute care costs in Australia. Injury prevention strategies should focus on targeted age-related mechanisms to reduce TBI in children.