Incidence of pediatric traumatic brain injury and associated hospital resource utilization in the United States

Andrew J Schneier, Brenda J Shields, Sarah Grim Hostetler, Huiyun Xiang, Gary A Smith
Pediatrics 2006, 118 (2): 483-92

OBJECTIVE: The goal was to examine the influence of sociodemographic characteristics and health care system factors on the utilization of hospital resources by US children < or = 17 years of age with a diagnosis of traumatic brain injury.

METHODS: A retrospective analysis of data from the Healthcare Cost and Utilization Project Kids' Inpatient Database, from January 1, 2000, to December 31, 2000, was performed. National estimates of traumatic brain injury-associated hospitalization rates and resource use were calculated with Kids' Inpatient Database sample weighting methods.

RESULTS: Of 2,516,833 encounters between January 1, 2000, and December 31, 2000, 25,783 cases involved patients < or = 17 years of age with a recorded diagnosis of traumatic brain injury. On the basis of these data, there were an estimated 50,658 traumatic brain injury-associated hospitalizations among children < or = 17 years of age in the United States in 2000. The traumatic brain injury-associated hospitalization rate was 70 cases per 100,000 children < or = 17 years of age per year; 15- to 17-year-old patients had the highest hospitalization rate (125 cases per 100,000 children per year). Pediatric inpatients accrued more than $1 billion in total charges for traumatic brain injury-associated hospitalizations in this study. In the multivariate regression models, older age, Medicaid insurance status, and admission to any type of children's hospital were associated with a longer length of stay for pediatric traumatic brain injury-associated hospitalizations. Older age, longer length of stay, and in-hospital death predicted higher total charges for traumatic brain injury-associated hospitalizations.

CONCLUSION: Pediatric traumatic brain injury is a substantial contributor to the health resource burden in the United States, accounting for more than $1 billion in total hospital charges annually.

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