Page 115 - DECISION-MAKING IN SEVERE TRAUMATIC BRAIN INJURY PATIENT OUTCOME, HOSPITAL COSTS, AND RESEARCH PRACTICE

Functional outcome and in-hospital costs after traumatic brain injury
INTRODUCTION
Recent estimates indicate that worldwide up to sixty-nine million people a year sustain
a traumatic brain injury (TBI). 1 The high incidence of TBI and the associated acute
and chronic sequelae cause substantial healthcare and socio-economic challenges.
2 Available treatments are unfortunately still largely unproven or unsatisfactory. 1-4
Patients suffer from the medical consequences of TBI, which range from headache and
fatigue to severe disabilities and even death. 5-9 The total global accompanying costs of
around US$ 400 billion a year are a major challenge from a socioeconomic perspective.
2 Especially considering the fact that TBI related healthcare costs are rising, while
healthcare budgets remain limited. 10 The in-hospital costs related to TBI represent 5 a substantial part of the total utilized resources. 11 Unfortunately, understanding and generalizing the in-hospital costs of individual TBI patients from available literature
remains difficult because methodological heterogeneity of TBI cost studies is high and study quality often inadequate. 12-14
Accurate insight in TBI related costs is essential to substantiate research initiatives that aim to improve treatment efficiency. It also guides policymakers on the rational allocation of resources without compromise of patient outcome. To allow healthcare professionals to continue to provide optimal care for their patients, high quality cost- analysis studies are urgently needed. 13,14
Therefore, the aim of this study is to describe outcome, in-hospital healthcare consumption and in-hospital costs of hospitalized TBI patients.
MATERIALS AND METHODS
This study followed the recommendations from the ‘Strengthening the Reporting of Observational Studies in Epidemiology’ STROBE statement. 15
Study design and patients
Patients were included in three level 1 trauma hospitals from January 2015 to September 2017. All hospitals are located in an urban area in the mid-Western part of the Netherlands and participated in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) project. The CENTER-
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