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道路交通事故后第一年创伤性脑损伤的增量成本。

The incremental cost of traumatic brain injury during the first year after a road traffic accident.

作者信息

Van Deynse Helena, Van Belleghem Griet, Lauwaert Door, Moens Maarten, Pien Karen, Devos Stefanie, Hubloue Ives, Putman Koen

机构信息

a Department of Public Health, Interuniversity Centre of Health Economics Research, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel , Brussels , Belgium.

b Emergency and Disaster Medicine, Department of Emergency Medicine, Universitair Ziekenhuis Brussel , Brussels , Belgium.

出版信息

Brain Inj. 2019;33(9):1234-1244. doi: 10.1080/02699052.2019.1641224. Epub 2019 Jul 12.

Abstract

This study aims to determine the incremental cost of TBI during the first year after a traffic accident, compared to other patients with similar non-TBI injuries. Secondly, identification of factors associated with medical costs of TBI is pursued. Analyses were performed on administrative data for traffic victims hospitalised in Belgium between 2009 and 2011. Medical costs attributable to the accident are estimated over one year post-injury. Cases with TBI were matched to controls with similar non-TBI injuries to determine the incremental cost of TBI. Both aims of this research were assessed using regression analysis. The incremental cost of TBI is estimated to range between € 10 042 (95%CI [€8198; €11 887]) and €21 715 (95%CI [€13 5889; €29 540]). Age, problems with self-reliance, survival status, the occurrence of acute events and severity of TBI are significant predictors of medical costs. As to healthcare utilisation, MRI usage, inpatient rehabilitation facilities, nursing homes and readmissions to acute hospital stand out as having most influence on costs. This study reveals a considerable incremental cost of TBI. Policy-making bodies should be made aware of this phenomenon and a diversified policy should be considered when financing programs are discussed.

摘要

本研究旨在确定交通事故后第一年创伤性脑损伤(TBI)相较于其他患有类似非TBI损伤患者的增量成本。其次,探寻与TBI医疗成本相关的因素。对2009年至2011年期间在比利时住院的交通受害者行政数据进行了分析。在受伤后一年时间内估算事故造成的医疗成本。将TBI病例与患有类似非TBI损伤的对照组进行匹配,以确定TBI的增量成本。本研究的两个目标均使用回归分析进行评估。TBI的增量成本估计在10,042欧元(95%置信区间[8198欧元;11,887欧元])至21,715欧元(95%置信区间[13,5889欧元;29,540欧元])之间。年龄、自理问题、生存状况、急性事件的发生以及TBI的严重程度是医疗成本的显著预测因素。至于医疗保健利用情况,MRI使用、住院康复设施、疗养院以及再次入住急性医院对成本的影响最为突出。本研究揭示了TBI相当可观的增量成本。政策制定机构应了解这一现象,在讨论筹资项目时应考虑制定多元化政策。

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