Kayani Noaman A, Homan Sherri, Yun Shumei, Zhu Bao Ping
Division of Community and Public Health, Missouri Department of Health and Senior Services, Jefferson City, MO 65102-0570, USA.
Public Health Rep. 2009 Jul-Aug;124(4):551-60. doi: 10.1177/003335490912400412.
We examined the financial and social costs resulting from traumatic brain injury (TBI) in Missouri.
We computed mortality rates from death certificates, the direct cost of TBI from hospital and emergency department (ED) visit charges, the social cost in terms of years of potential life lost (YPLL) using an abridged Missouri life table, and the indirect financial cost in terms of lost productivity due to premature death for all TBI and four major causes of TBI in Missouri.
During 2001-2005, a mean of 1358 lives were lost due to TBI in Missouri. Four major causes-unintentional falls, motor vehicle traffic crashes, motorcycle crashes, and firearms-accounted for 88% of all TBI deaths. We estimated the annual direct medical cost of TBI at $95 million, or about $1.67 million per 100,000 Missourians. This cost increased by about 60% between 2001 and 2005. The four major causes of TBI accounted for 68% of all direct medical costs of TBI. We estimated the cost per hospitalization and ED visit at $6948 and the indirect social cost at 48,501 YPLL. During this period, the mean age of TBI fatality was 44 years. We determined the lost productivity due to TBI mortality--$1.1 billion, or about $18.8 million per 100,000 Missourians--to be three times as high for males as for females.
The types of costs covered in this study underestimated the total cost of TBI in Missouri, as we did not include outpatient care, rehabilitation, and drug costs. Nevertheless, we found the health and economic burden from medical care and mortality related to TBI to be substantial in Missouri.
我们研究了密苏里州创伤性脑损伤(TBI)所导致的经济和社会成本。
我们根据死亡证明计算死亡率,根据医院和急诊科就诊费用计算TBI的直接成本,使用简略的密苏里生命表计算潜在寿命损失年数(YPLL)方面的社会成本,以及密苏里州所有TBI及TBI的四个主要病因所致过早死亡造成的生产力损失方面的间接经济成本。
在2001 - 2005年期间,密苏里州平均每年有1358人因TBI死亡。四个主要病因——意外跌倒、机动车交通事故、摩托车事故和火器——占所有TBI死亡人数的88%。我们估计TBI的年度直接医疗成本为9500万美元,即每10万密苏里人约167万美元。该成本在2001年至2005年期间增长了约60%。TBI的四个主要病因占TBI所有直接医疗成本的68%。我们估计每次住院和急诊就诊的成本为6948美元,间接社会成本为48501个潜在寿命损失年数。在此期间,TBI死亡者的平均年龄为44岁。我们确定因TBI死亡造成的生产力损失为11亿美元,即每10万密苏里人约1880万美元,男性的这一损失是女性的三倍。
本研究涵盖的成本类型低估了密苏里州TBI的总成本,因为我们未包括门诊护理、康复和药物成本。尽管如此,我们发现密苏里州与TBI相关的医疗护理和死亡率所带来的健康和经济负担相当大。