Health & Economic Burden of Traumatic Brain Injury in the Emergency Department
Objective: To evaluate epidemiological patterns and lifetime costs of traumatic brain injury (TBI) identified in the emergency department (ED) within a publicly insured population in Ontario, Canada, in 2009. Methods: A nationally representative, population-based database was used to identify TBI ca...
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Published in | Canadian journal of neurological sciences Vol. 43; no. 2; pp. 238 - 247 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
New York, USA
Cambridge University Press
01.03.2016
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Subjects | |
Online Access | Get full text |
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Abstract | Objective:
To evaluate epidemiological patterns and lifetime costs of traumatic brain injury (TBI) identified in the emergency department (ED) within a publicly insured population in Ontario, Canada, in 2009.
Methods:
A nationally representative, population-based database was used to identify TBI cases presenting to Ontario EDs between April 2009 and March 2010. We calculated unit costs for medical treatment and productivity loss, and multiplied these by corresponding incidence estimates to determine the lifetime costs of identified TBI cases across age group, sex, and mechanism of injury.
Results:
In 2009, there were more than 133,000 ED visits for TBI in Ontario, resulting in a conservative estimate of $945 million in lifetime costs. Lifetime cost estimates ranged from $279 million to $1.22 billion depending on the diagnostic criteria used to define TBI. Peak rates of TBI occurred among young children (ages 0-4 year) and the elderly (ages 85+ years). Males experienced a 53% greater rate of TBI and incurred two-fold higher costs compared with females. Falls, sports/bicyclist-related injuries, and motor vehicle crashes represented 47%, 12%, and 10% of TBI presenting to ED, respectively, and accounted for a significant proportion of costs.
Conclusions:
This study revealed an enormous health and economic burden associated with TBI identified in the ED setting. Our findings underscore the importance of ongoing surveillance and prevention efforts targeted to vulnerable populations. More research is needed to fully appreciate the burden of TBI across a variety of health care settings.
Fardeau économique et fardeau de santé de lésions cérébrales traumatiques identifiées au service des urgences.
Objectif:
Le but de cette étude était d’évaluer le tableau épidémiologique et les coûts pendant la durée de vie de lésions cérébrales traumatiques (LCT) identifiées au service des urgences (SU) dans une population assurée par un régime publique en Ontario, au Canada, en 2009.
Méthode:
Une base de données populationnelles représentatives au niveau national a été utilisée pour identifier les cas de LCT s’étant présentés au SU en Ontario entre avril 2009 et mars 2010. Nous avons calculé les coûts unitaires du traitement médical et de la perte de productivité et nous avons multiplié ces coûts par les estimés correspondants d’incidence afin de déterminer les coûts à vie des cas de LCT identifiés selon les groupes d’âge, le sexe et le mécanisme de la lésion.
Résultats:
En 2009, il y a eu plus de 133,000 visites au SU pour des LCT en Ontario. Ainsi, on peut estimer de façon conservatrice des coûts afférents à vie de 945 millions de dollars. Les estimés des coûts à vie allaient de 279 millions de dollars à 1,22 billion, selon les critères diagnostiques utilisés pour définir la LCT. Les jeunes enfants entre 0 et 4 ans et les vieillards de 85 ans et plus avaient les taux les plus élevés de LCT. Le taux de LCT chez les hommes était de 53% plus élevé que celui des femmes et les coûts encourus étaient deux fois plus élevés que ceux des femmes. Les chutes, les traumatismes chez les sportifs et les cyclistes ainsi que les accidents de la route étaient respectivement la cause de 47%, 12% et 10% des cas de LCT se présentant au SU et représentaient une proportion importante des coûts.
Conclusion:
Cette étude a démontré que le fardeau de santé et le fardeau économique en lien aux LCT identifiées au SU sont énormes. Nos observations soulignent l’importance des mesures de surveillance et de prévention ciblant les populations vulnérables. De plus amples recherches sont nécessaires pour évaluer plus précisément le fardeau que constituent les LCT dans différents établissements de santé. |
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AbstractList | Objective: To evaluate epidemiological patterns and lifetime costs of traumatic brain injury (TBI) identified in the emergency department (ED) within a publicly insured population in Ontario, Canada, in 2009. Methods: A nationally representative, population-based database was used to identify TBI cases presenting to Ontario EDs between April 2009 and March 2010. We calculated unit costs for medical treatment and productivity loss, and multiplied these by corresponding incidence estimates to determine the lifetime costs of identified TBI cases across age group, sex, and mechanism of injury. Results: In 2009, there were more than 133,000 ED visits for TBI in Ontario, resulting in a conservative estimate of $945 million in lifetime costs. Lifetime cost estimates ranged from $279 million to $1.22 billion depending on the diagnostic criteria used to define TBI. Peak rates of TBI occurred among young children (ages 0-4 year) and the elderly (ages 85+ years). Males experienced a 53% greater rate of TBI and incurred two-fold higher costs compared with females. Falls, sports/bicyclist-related injuries, and motor vehicle crashes represented 47%, 12%, and 10% of TBI presenting to ED, respectively, and accounted for a significant proportion of costs. Conclusions: This study revealed an enormous health and economic burden associated with TBI identified in the ED setting. Our findings underscore the importance of ongoing surveillance and prevention efforts targeted to vulnerable populations. More research is needed to fully appreciate the burden of TBI across a variety of health care settings. Objective: To evaluate epidemiological patterns and lifetime costs of traumatic brain injury (TBI) identified in the emergency department (ED) within a publicly insured population in Ontario, Canada, in 2009. Methods: A nationally representative, population-based database was used to identify TBI cases presenting to Ontario EDs between April 2009 and March 2010. We calculated unit costs for medical treatment and productivity loss, and multiplied these by corresponding incidence estimates to determine the lifetime costs of identified TBI cases across age group, sex, and mechanism of injury. Results: In 2009, there were more than 133,000 ED visits for TBI in Ontario, resulting in a conservative estimate of $945 million in lifetime costs. Lifetime cost estimates ranged from $279 million to $1.22 billion depending on the diagnostic criteria used to define TBI. Peak rates of TBI occurred among young children (ages 0-4 year) and the elderly (ages 85+ years). Males experienced a 53% greater rate of TBI and incurred two-fold higher costs compared with females. Falls, sports/bicyclist-related injuries, and motor vehicle crashes represented 47%, 12%, and 10% of TBI presenting to ED, respectively, and accounted for a significant proportion of costs. Conclusions: This study revealed an enormous health and economic burden associated with TBI identified in the ED setting. Our findings underscore the importance of ongoing surveillance and prevention efforts targeted to vulnerable populations. More research is needed to fully appreciate the burden of TBI across a variety of health care settings. Fardeau économique et fardeau de santé de lésions cérébrales traumatiques identifiées au service des urgences. Objectif: Le but de cette étude était d’évaluer le tableau épidémiologique et les coûts pendant la durée de vie de lésions cérébrales traumatiques (LCT) identifiées au service des urgences (SU) dans une population assurée par un régime publique en Ontario, au Canada, en 2009. Méthode: Une base de données populationnelles représentatives au niveau national a été utilisée pour identifier les cas de LCT s’étant présentés au SU en Ontario entre avril 2009 et mars 2010. Nous avons calculé les coûts unitaires du traitement médical et de la perte de productivité et nous avons multiplié ces coûts par les estimés correspondants d’incidence afin de déterminer les coûts à vie des cas de LCT identifiés selon les groupes d’âge, le sexe et le mécanisme de la lésion. Résultats: En 2009, il y a eu plus de 133,000 visites au SU pour des LCT en Ontario. Ainsi, on peut estimer de façon conservatrice des coûts afférents à vie de 945 millions de dollars. Les estimés des coûts à vie allaient de 279 millions de dollars à 1,22 billion, selon les critères diagnostiques utilisés pour définir la LCT. Les jeunes enfants entre 0 et 4 ans et les vieillards de 85 ans et plus avaient les taux les plus élevés de LCT. Le taux de LCT chez les hommes était de 53% plus élevé que celui des femmes et les coûts encourus étaient deux fois plus élevés que ceux des femmes. Les chutes, les traumatismes chez les sportifs et les cyclistes ainsi que les accidents de la route étaient respectivement la cause de 47%, 12% et 10% des cas de LCT se présentant au SU et représentaient une proportion importante des coûts. Conclusion: Cette étude a démontré que le fardeau de santé et le fardeau économique en lien aux LCT identifiées au SU sont énormes. Nos observations soulignent l’importance des mesures de surveillance et de prévention ciblant les populations vulnérables. De plus amples recherches sont nécessaires pour évaluer plus précisément le fardeau que constituent les LCT dans différents établissements de santé. Objective: To evaluate epidemiological patterns and lifetime costs of traumatic brain injury (TBI) identified in the emergency department (ED) within a publicly insured population in Ontario, Canada, in 2009. Methods: A nationally representative, population-based database was used to identify TBI cases presenting to Ontario EDs between April 2009 and March 2010. We calculated unit costs for medical treatment and productivity loss, and multiplied these by corresponding incidence estimates to determine the lifetime costs of identified TBI cases across age group, sex, and mechanism of injury. Results: In 2009, there were more than 133,000 ED visits for TBI in Ontario, resulting in a conservative estimate of $945 million in lifetime costs. Lifetime cost estimates ranged from $279 million to $1.22 billion depending on the diagnostic criteria used to define TBI. Peak rates of TBI occurred among young children (ages 0-4 year) and the elderly (ages 85+ years). Males experienced a 53% greater rate of TBI and incurred two-fold higher costs compared with females. Falls, sports/bicyclist-related injuries, and motor vehicle crashes represented 47%, 12%, and 10% of TBI presenting to ED, respectively, and accounted for a significant proportion of costs. Conclusions: This study revealed an enormous health and economic burden associated with TBI identified in the ED setting. Our findings underscore the importance of ongoing surveillance and prevention efforts targeted to vulnerable populations. More research is needed to fully appreciate the burden of TBI across a variety of health care settings.Original Abstract: Objectif: Le but de cette etude etait d'evaluer le tableau epidemiologique et les couts pendant la duree de vie de lesions cerebrales traumatiques (LCT) identifiees au service des urgences (SU) dans une population assuree par un regime publique en Ontario, au Canada, en 2009. Methode: Une base de donnees populationnelles representatives au niveau national a ete utilisee pour identifier les cas de LCT s'etant presentes au SU en Ontario entre avril 2009 et mars 2010. Nous avons calcule les couts unitaires du traitement medical et de la perte de productivite et nous avons multiplie ces couts par les estimes correspondants d'incidence afin de determiner les couts a vie des cas de LCT identifies selon les groupes d'age, le sexe et le mecanisme de la lesion. Resultats: En 2009, il y a eu plus de 133,000 visites au SU pour des LCT en Ontario. Ainsi, on peut estimer de facon conservatrice des couts afferents a vie de 945 millions de dollars. Les estimes des couts a vie allaient de 279 millions de dollars a 1,22 billion, selon les criteres diagnostiques utilises pour definir la LCT. Les jeunes enfants entre 0 et 4 ans et les vieillards de 85 ans et plus avaient les taux les plus eleves de LCT. Le taux de LCT chez les hommes etait de 53% plus eleve que celui des femmes et les couts encourus etaient deux fois plus eleves que ceux des femmes. Les chutes, les traumatismes chez les sportifs et les cyclistes ainsi que les accidents de la route etaient respectivement la cause de 47%, 12% et 10% des cas de LCT se presentant au SU et representaient une proportion importante des couts. Conclusion: Cette etude a demontre que le fardeau de sante et le fardeau economique en lien aux LCT identifiees au SU sont enormes. Nos observations soulignent l'importance des mesures de surveillance et de prevention ciblant les populations vulnerables. De plus amples recherches sont necessaires pour evaluer plus precisement le fardeau que constituent les LCT dans differents etablissements de sante. Abstract Objective: To evaluate epidemiological patterns and lifetime costs of traumatic brain injury (TBI) identified in the emergency department (ED) within a publicly insured population in Ontario, Canada, in 2009. Methods: A nationally representative, population-based database was used to identify TBI cases presenting to Ontario EDs between April 2009 and March 2010. We calculated unit costs for medical treatment and productivity loss, and multiplied these by corresponding incidence estimates to determine the lifetime costs of identified TBI cases across age group, sex, and mechanism of injury. Results: In 2009, there were more than 133,000 ED visits for TBI in Ontario, resulting in a conservative estimate of $945 million in lifetime costs. Lifetime cost estimates ranged from $279 million to $1.22 billion depending on the diagnostic criteria used to define TBI. Peak rates of TBI occurred among young children (ages 0-4 year) and the elderly (ages 85+ years). Males experienced a 53% greater rate of TBI and incurred two-fold higher costs compared with females. Falls, sports/bicyclist-related injuries, and motor vehicle crashes represented 47%, 12%, and 10% of TBI presenting to ED, respectively, and accounted for a significant proportion of costs. Conclusions: This study revealed an enormous health and economic burden associated with TBI identified in the ED setting. Our findings underscore the importance of ongoing surveillance and prevention efforts targeted to vulnerable populations. More research is needed to fully appreciate the burden of TBI across a variety of health care settings. RÉSUMÉ Fardeau économique et fardeau de santé de lésions cérébrales traumatiques identifiées au service des urgences. Objectif: Le but de cette étude était d’évaluer le tableau épidémiologique et les coûts pendant la durée de vie de lésions cérébrales traumatiques (LCT) identifiées au service des urgences (SU) dans une population assurée par un régime publique en Ontario, au Canada, en 2009. Méthode: Une base de données populationnelles représentatives au niveau national a été utilisée pour identifier les cas de LCT s’étant présentés au SU en Ontario entre avril 2009 et mars 2010. Nous avons calculé les coûts unitaires du traitement médical et de la perte de productivité et nous avons multiplié ces coûts par les estimés correspondants d’incidence afin de déterminer les coûts à vie des cas de LCT identifiés selon les groupes d’âge, le sexe et le mécanisme de la lésion. Résultats: En 2009, il y a eu plus de 133,000 visites au SU pour des LCT en Ontario. Ainsi, on peut estimer de façon conservatrice des coûts afférents à vie de 945 millions de dollars. Les estimés des coûts à vie allaient de 279 millions de dollars à 1,22 billion, selon les critères diagnostiques utilisés pour définir la LCT. Les jeunes enfants entre 0 et 4 ans et les vieillards de 85 ans et plus avaient les taux les plus élevés de LCT. Le taux de LCT chez les hommes était de 53% plus élevé que celui des femmes et les coûts encourus étaient deux fois plus élevés que ceux des femmes. Les chutes, les traumatismes chez les sportifs et les cyclistes ainsi que les accidents de la route étaient respectivement la cause de 47%, 12% et 10% des cas de LCT se présentant au SU et représentaient une proportion importante des coûts. Conclusion: Cette étude a démontré que le fardeau de santé et le fardeau économique en lien aux LCT identifiées au SU sont énormes. Nos observations soulignent l’importance des mesures de surveillance et de prévention ciblant les populations vulnérables. De plus amples recherches sont nécessaires pour évaluer plus précisément le fardeau que constituent les LCT dans différents établissements de santé. OBJECTIVETo evaluate epidemiological patterns and lifetime costs of traumatic brain injury (TBI) identified in the emergency department (ED) within a publicly insured population in Ontario, Canada, in 2009.METHODSA nationally representative, population-based database was used to identify TBI cases presenting to Ontario EDs between April 2009 and March 2010. We calculated unit costs for medical treatment and productivity loss, and multiplied these by corresponding incidence estimates to determine the lifetime costs of identified TBI cases across age group, sex, and mechanism of injury.RESULTSIn 2009, there were more than 133,000 ED visits for TBI in Ontario, resulting in a conservative estimate of $945 million in lifetime costs. Lifetime cost estimates ranged from $279 million to $1.22 billion depending on the diagnostic criteria used to define TBI. Peak rates of TBI occurred among young children (ages 0-4 year) and the elderly (ages 85+ years). Males experienced a 53% greater rate of TBI and incurred two-fold higher costs compared with females. Falls, sports/bicyclist-related injuries, and motor vehicle crashes represented 47%, 12%, and 10% of TBI presenting to ED, respectively, and accounted for a significant proportion of costs.CONCLUSIONSThis study revealed an enormous health and economic burden associated with TBI identified in the ED setting. Our findings underscore the importance of ongoing surveillance and prevention efforts targeted to vulnerable populations. More research is needed to fully appreciate the burden of TBI across a variety of health care settings. To evaluate epidemiological patterns and lifetime costs of traumatic brain injury (TBI) identified in the emergency department (ED) within a publicly insured population in Ontario, Canada, in 2009. A nationally representative, population-based database was used to identify TBI cases presenting to Ontario EDs between April 2009 and March 2010. We calculated unit costs for medical treatment and productivity loss, and multiplied these by corresponding incidence estimates to determine the lifetime costs of identified TBI cases across age group, sex, and mechanism of injury. In 2009, there were more than 133,000 ED visits for TBI in Ontario, resulting in a conservative estimate of $945 million in lifetime costs. Lifetime cost estimates ranged from $279 million to $1.22 billion depending on the diagnostic criteria used to define TBI. Peak rates of TBI occurred among young children (ages 0-4 year) and the elderly (ages 85+ years). Males experienced a 53% greater rate of TBI and incurred two-fold higher costs compared with females. Falls, sports/bicyclist-related injuries, and motor vehicle crashes represented 47%, 12%, and 10% of TBI presenting to ED, respectively, and accounted for a significant proportion of costs. This study revealed an enormous health and economic burden associated with TBI identified in the ED setting. Our findings underscore the importance of ongoing surveillance and prevention efforts targeted to vulnerable populations. More research is needed to fully appreciate the burden of TBI across a variety of health care settings. |
Author | Cusimano, Michael D. Fu, Terence S. Jing, Rowan McFaull, Steven R. |
Author_xml | – sequence: 1 givenname: Terence S. surname: Fu fullname: Fu, Terence S. organization: Division of Neurosurgery, Department of Surgery, St. Michael’s Hospital, Toronto, Ontario, Canada – sequence: 2 givenname: Rowan surname: Jing fullname: Jing, Rowan organization: Division of Neurosurgery, Department of Surgery, St. Michael’s Hospital, Toronto, Ontario, Canada – sequence: 3 givenname: Steven R. surname: McFaull fullname: McFaull, Steven R. organization: Public Health Agency of Canada, Toronto, Ontario, Canada – sequence: 4 givenname: Michael D. surname: Cusimano fullname: Cusimano, Michael D. email: injuryprevention@smh.ca organization: Division of Neurosurgery, Department of Surgery, St. Michael’s Hospital, Toronto, Ontario, Canada |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26842131$$D View this record in MEDLINE/PubMed |
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ContentType | Journal Article |
Copyright | Copyright © The Canadian Journal of Neurological Sciences Inc. 2016 |
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To evaluate epidemiological patterns and lifetime costs of traumatic brain injury (TBI) identified in the emergency department (ED) within a... To evaluate epidemiological patterns and lifetime costs of traumatic brain injury (TBI) identified in the emergency department (ED) within a publicly insured... Abstract Objective: To evaluate epidemiological patterns and lifetime costs of traumatic brain injury (TBI) identified in the emergency department (ED) within... Objective: To evaluate epidemiological patterns and lifetime costs of traumatic brain injury (TBI) identified in the emergency department (ED) within a... OBJECTIVETo evaluate epidemiological patterns and lifetime costs of traumatic brain injury (TBI) identified in the emergency department (ED) within a publicly... |
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SubjectTerms | Adolescent Adult Age Distribution Aged Aged, 80 and over Brain Injuries, Traumatic - economics Brain Injuries, Traumatic - epidemiology Brain Injuries, Traumatic - etiology Child Child, Preschool Cost of Illness Discount rates Emergency Service, Hospital Fatalities Female Humans Incidence Infant Infant, Newborn Male Middle Aged Mortality Ontario - epidemiology Original Articles Sex Distribution Traumatic brain injury Young Adult |
Title | Health & Economic Burden of Traumatic Brain Injury in the Emergency Department |
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