Tuominen Risto, Joelsson Petteri, Tenovuo Olli
Department of Public Health, University of Turku, Finland.
Brain Inj. 2012;26(13-14):1697-701. doi: 10.3109/02699052.2012.722256.
To estimate the magnitude and relative importance of hospital treatment costs and productivity losses caused by traumatic brain injuries (TBIs).
A total of 155 patients with new TBI diagnoses admitted to Turku University Hospital were systematically sampled.
Hospital costs were determined by collecting detailed data from patient records and applying the actual cost from the hospital administration. For estimating the productivity losses, the age of retirement was adjusted according to the age- and sex-specific retirement probability.
Median treatment costs per TBI patient were €5429, surgery €1600 and other costs €3651. Overall treatment costs for severe brain injuries were significantly (p < 0.01) higher than for less severe cases. Median production losses due to early retirement were estimated to be €1.19 million per TBI patient, significantly (p < 0.03) lower among less severe than among the severe cases. Age, sex and severity of TBI could explain only 9% of the variation in treatment costs, but explained 73% of the variation in production losses.
Indirect productivity losses form the great majority of the overall economic burden of TBI to society. The direct treatment costs in tertiary level hospitals also impose a considerable burden on the healthcare sector.
评估创伤性脑损伤(TBI)所致医院治疗费用及生产力损失的规模和相对重要性。
对图尔库大学医院收治的155例新诊断为TBI的患者进行系统抽样。
通过收集患者病历的详细数据并应用医院管理部门的实际成本来确定医院成本。为估算生产力损失,根据年龄和性别特异性退休概率调整退休年龄。
每位TBI患者的治疗费用中位数为5429欧元,手术费用为1600欧元,其他费用为3651欧元。重度脑损伤的总体治疗费用显著高于(p < 0.01)轻度脑损伤病例。因提前退休导致的生产力损失中位数估计为每位TBI患者119万欧元,轻度病例显著低于(p < 0.03)重度病例。TBI的年龄、性别和严重程度仅能解释治疗费用变化的9%,但能解释生产力损失变化的73%。
间接生产力损失构成了TBI对社会总体经济负担的绝大部分。三级医院的直接治疗费用也给医疗保健部门带来了相当大的负担。