Research Reports - Cost prediction following traumatic brain injury

J Neurol Neurosurg Psychiatry. 2015 Feb 18

Spitz G(1), McKenzie D(2), Attwood D(3), Ponsford JL(1)

OBJECTIVE: The ability to predict costs following a traumatic brain injury (TBI)
would assist in planning treatment and support services by healthcare providers,
insurers and other agencies. The objective of the current study was to develop
predictive models of hospital, medical, paramedical, and long-term care (LTC)
costs for the first 10 years following a TBI.
METHODS: The sample comprised 798 participants with TBI, the majority of whom
were male and aged between 15 and 34 at time of injury. Costing information was
obtained for hospital, medical, paramedical, and LTC costs up to 10 years
postinjury. Demographic and injury-severity variables were collected at the time
of admission to the rehabilitation hospital.
RESULTS: Duration of PTA was the most important single predictor for each cost
type. The final models predicted 44% of hospital costs, 26% of medical costs, 23%
of paramedical costs, and 34% of LTC costs. Greater costs were incurred,
depending on cost type, for individuals with longer PTA duration, obtaining a
limb or chest injury, a lower GCS score, older age at injury, not being married
or defacto prior to injury, living in metropolitan areas, and those reporting
premorbid excessive or problem alcohol use.
CONCLUSIONS: This study has provided a comprehensive analysis of factors
predicting various types of costs following TBI, with the combination of
injury-related and demographic variables predicting 23-44% of costs. PTA duration
was the strongest predictor across all cost categories. These factors may be used
for the planning and case management of individuals following TBI.

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