Abstract
BackgroundPatients with acquired brain damage (ABD) have suffered a brain lesion that interrupts vital development in the physical, psychological and social spheres. Stroke and traumatic brain injury (TBI) are the two main causes. The objectives of this study were to estimate the incidence and prevalence of ABD in the population of the Basque Country and Navarre in 2008, to calculate the associated cost of the care required and finally to assess the loss in health-related quality of life.MethodsOn the one hand, a cross-sectional survey was carried out, in order to estimate the incidence of ABD and its consequences in terms of costs and loss in quality of life from the evolution of a sample of patients diagnosed with stroke and TBI. On the other hand, a discrete event simulation model was built that enabled the prevalence of ABD to be estimated. Finally, a calculation was made of the formal and informal costs of ABD in the population of the Basque Country and Navarre (2,750,000 people).ResultsThe cross-sectional study showed that the incidences of ABD caused by stroke and TBI were 61.8 and 12.5 cases per 100,000 per year respectively, while the overall prevalence was 657 cases per 100,000 people. The SF-36 physical and mental component scores were 28.9 and 44.5 respectively. The total economic burden was calculated to be 382.14 million euro per year, distributed between 215.27 and 166.87 of formal and informal burden respectively. The average cost per individual was 21,040 € per year.ConclusionsThe main conclusion of this study is that ABD has a high impact in both epidemiological and economic terms as well as loss in quality of life. The overall prevalence obtained is equivalent to 0.7% of the total population. The substantial economic burden is distributed nearly evenly between formal and informal costs. Specifically, it was found that the physical dimensions of quality of life are the most severely affected. The prevalence-based approach showed adequate to estimate the population impact of ABD and the resources needed to compensate the disability.
Highlights
Patients with acquired brain damage (ABD) have suffered a brain lesion that interrupts vital development in the physical, psychological and social spheres
Survey for patients with stroke and traumatic brain injury (TBI) The scope of this study was the geographical area of the Basque Country and Navarre, two regions in the north of Spain, with a total population of 2.75 million, the socio-demographic characteristics being similar in the two areas
In order to identify the incidence, and the economic and Health-Related Quality of Life (HRQL) impact, a survey was used with patients who had been diagnosed with stroke or TBI in five hospitals in the area
Summary
Patients with acquired brain damage (ABD) have suffered a brain lesion that interrupts vital development in the physical, psychological and social spheres. Stroke and traumatic brain injury (TBI) are the two main causes. In the case of acute lesions and diseases that affect the brain, there is plenty of work in the literature analysing their causes, including stroke and traumatic brain injury (TBI) [2,3,4,5,6]. The natural history of these patients varies depending on the aetiology. What they all have in common is a transition to certain level of disability that typically requires specific social and health care and represents a great loss in quality of life [9]
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