Graves Janessa M, Rivara Frederick P, Vavilala Monica S
All of the authors are with the Harborview Injury and Research Center (HIPRC), Seattle, WA. Janessa M. Graves is also with the College of Nursing, Washington State University Spokane. Frederick P. Rivara is also with the Departments of Epidemiology and Pediatrics, University of Washington, Seattle. Monica S. Vavilala is also with the Departments of Pediatrics and Anesthesiology & Pain Medicine, University of Washington.
Am J Public Health. 2015 Oct;105(10):e35-41. doi: 10.2105/AJPH.2015.302744. Epub 2015 Aug 13.
This study sought to estimate total health care costs for mild, moderate, and severe pediatric traumatic brain injury (TBI) and to compare individual- and population-level costs across levels of TBI severity.
Using 2007 to 2010 MarketScan Commercial Claims and Encounters data, we estimated total quarterly health care costs 1 year after TBI among enrollees (aged < 18 years). We compared costs across levels of TBI severity using generalized linear models.
Mild TBI accounted for 96.6% of the 319 103 enrollees with TBI; moderate and severe TBI accounted for 1.7% and 1.6%, respectively. Adjusted individual health care costs for moderate and severe TBI were significantly higher than mild TBI in the year after injury (P < .01). At the population level, moderate and severe TBI costs were 88% and 75% less than mild TBI, respectively.
Individually, moderate and severe TBI initially generated costs that were markedly higher than those of mild TBI. At the population level, costs following mild TBI far exceeded those of more severe cases, a result of the extremely high population burden of mild TBI.
本研究旨在估算轻度、中度和重度小儿创伤性脑损伤(TBI)的总医疗费用,并比较不同严重程度TBI的个体和总体费用。
利用2007年至2010年市场扫描商业索赔和就诊数据,我们估算了TBI发生1年后(年龄<18岁)参保者的季度总医疗费用。我们使用广义线性模型比较了不同严重程度TBI的费用。
在319103例TBI参保者中,轻度TBI占96.6%;中度和重度TBI分别占1.7%和1.6%。受伤后一年内,中度和重度TBI的调整后个体医疗费用显著高于轻度TBI(P<0.01)。在总体水平上,中度和重度TBI的费用分别比轻度TBI低88%和75%。
就个体而言,中度和重度TBI最初产生的费用明显高于轻度TBI。在总体水平上,轻度TBI后的费用远远超过更严重病例的费用,这是轻度TBI极高的总体负担导致的结果。