A Population-Based Sex-Stratified Study to Understand How Health Status Preceding Traumatic Brain Injury Affects Direct Medical Cost

• Published in: Archives of physical medicine and rehabilitation Vol. 102; no. 10; pp. e32 - e33
• Main Authors: Chan, Vincy, Hurst, Mackenzie, Petersen, Tierza, Liu, Jingqian, Mollayeva, Tatyana, Colantonio, Angela, Sutton, Mitchell, Escobar, Michael
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.10.2021
• Subjects: Brain Injuries; Comorbidity International Classification of Disease; Health Care Costs; Health Expenditures; Health Care Costs; Comorbidity International Classification of Disease; Brain Injuries; Health Expenditures
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2021.07.555

To understand how pre-injury health status present five-years preceding traumatic brain injury (TBI) affects direct medical cost two years post-injury. Retrospective cohort study. Publicly funded healthcare system in Ontario, Canada. Patients age 19 years or older in the emergency department (ED) or acute care for a TBI between April 1, 2007 and March 31, 2014 (N=55,669). N/A. Direct medical costs within two years of discharge. Patients who received care in the ED (81.9% of total sample) incurred a median cost of $2,492/male patient (average $12,342/patient) and $3,508/female patient (average $12,372/patient) within two years of injury; 37 pre-injury factors were significantly associated with increased direct medical costs. Patients who first received care for their TBI in acute care (18.1%) incurred a median cost of $25,081/male patient (average $63,060/patient) and $30,277/female patient (average $65,285/patient) within two years of injury; 21 factors were significantly associated with increased direct medical costs. Among more prevalent factors, those associated with increased medical cost by at least 50% included mental health disorders, substance abuse, disorders or medical conditions frequently observed among the elderly, cardiovascular disorders, stroke and emergencies involving the brain, metabolic disorders and abdominal symptoms, conditions and symptoms of abdomen and pelvis, genitourinary disorders and disorders of prostate, and pulmonary abdominal and other emergencies. Direct medical costs two years post-TBI differed significantly between patients with and without adverse pre-existing health status. Interdisciplinary teams to promote early identification of pre-existing health conditions and appropriate management and integration of these conditions in TBI care across the continuum of healthcare may be opportunities to reduce direct medical costs post-injury. None.