Abstract
Background: Traumatic brain injury (TBI) is an increasingly diagnosed condition, but the trends in TBI visits and the cost of which have not been quantified from the hospital perspective. Objectives: To quantify the costs of TBI stratified by inpatient and outpatient visits and to examine trends in TBI incidence over time. Methods: This descriptive study utilized data for 2007-2012 from the Premier hospital database, which includes clinical and utilization information from hospitals across the United States. TBI was identified through International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. Descriptive data were obtained to identify the TBI costs, visit costs, patient characteristics, and intertemporal trends in TBI rates. Results: TBI patients were treated on an outpatient basis 88% of the time. Nearly 45% (44.3%) of TBI patients requiring inpatient admissions were age 65 or over, and 20% of TBI patients treated as an outpatient were age 75 or over. Children aged 4 or younger accounted for nearly 14% of TBI cases treated on an outpatient basis. TBI patients treated in the inpatient setting incurred fairly long hospital visits (mean 4.8 days; median 3.0 days) and substantial hospital costs (mean $12,717; median $8,176). The rate of TBI visits have risen substantially over time, especially among children under age 18 years and patients in the Northeast US Census Region. Conclusion: TBI is a serious medical condition that appears to be on the rise. Large differences exist between the hospital costs associated with TBIs treated in the inpatient and outpatient settings. Further research to understand factors affecting the costs and clinical outcomes of TBI can help refine treatment strategies to enhance patient outcomes while providing cost effective care.
Highlights
Traumatic brain injury (TBI) is common in the United States, with an estimated 1.7 million occurrences each year.[1]
TBI is a serious medical condition that appears to be on the rise
Large differences exist between the hospital costs associated with TBIs treated in the inpatient and outpatient settings
Summary
Traumatic brain injury (TBI) is common in the United States, with an estimated 1.7 million occurrences each year.[1] According to a 2010 Centers Disease Control and Prevention (CDC) report, TBI results in 275,000 hospitalizations and 52,000 deaths annually.[1] Annual costs attributed to TBI are substantial in the United States, with an estimated $76.5 billion in direct medical costs and indirect costs, such as lost productivity and wages.[1,2]. Whitmore et al.[5] argued for aggressive treatment of severe TBI based on their cost-effective analysis. In their decision-analytic model, the researchers found that for the average 20 year-old, aggressive care yields a highly significant difference in quality-adjusted life years gained (p
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