| Title |
The cost of a pediatric neurocritical care program for traumatic brain injury: a retrospective cohort study
|
|---|---|
| Published in |
BMC Health Services Research, January 2018
|
| DOI | 10.1186/s12913-017-2768-0 |
| Pubmed ID | |
| Authors |
Steven W. Howard, Zidong Zhang, Paula Buchanan, Stephanie L. Bernell, Christine Williams, Lindsey Pearson, Michael Huetsch, Jeff Gill, Jose A. Pineda |
| Abstract |
Inpatient care for children with severe traumatic brain injury (sTBI) is expensive, with inpatient charges averaging over $70,000 per case (Hospital Inpatient, Children Only, National Statistics. Diagnoses- clinical classification software (CCS) principal diagnosis category 85 coma, stupor, and brain damage, and 233 intracranial injury. Diagnoses by Aggregate charges [ https://hcupnet.ahrq.gov/#setup ]). This ranks sTBI in the top quartile of pediatric conditions with the greatest inpatient costs (Hospital Inpatient, Children Only, National Statistics. Diagnoses- clinical classification software (CCS) principal diagnosis category 85 coma, stupor, and brain damage, and 233 intracranial injury. Diagnoses by Aggregate charges [ https://hcupnet.ahrq.gov/#setup ]). The Brain Trauma Foundation developed sTBI intensive care guidelines in 2003, with revisions in 2012 (Kochanek, Carney, et. al. PCCM 3:S1-S2, 2012). These guidelines have been widely disseminated, and are associated with improved health outcomes (Pineda, Leonard. et. al. LN 12:45-52, 2013), yet research on the cost of associated hospital care is limited. The objective of this study was to assess the costs of providing hospital care to sTBI patients through a guideline-based Pediatric Neurocritical Care Program (PNCP) implemented at St. Louis Children's Hospital, a pediatric academic medical center in the Midwest United States. This is a retrospective cohort study. We used multi-level regression to estimate pre-/post-implementation effects of the PNCP program on inflation adjusted total cost of in-hospital sTBI care. The study population included 58 pediatric patient discharges in the pre-PNCP implementation group (July 15, 1999 - September 17, 2005), and 59 post-implementation patient discharges (September 18, 2005 - January 15, 2012). Implementation of the PNCP was associated with a non-significant difference in the cost of care between the pre- and post-implementation periods (eβ = 1.028, p = 0.687). Implementation of the PNCP to support delivery of guideline-based care for children with sTBI did not change the total per-patient cost of in-hospital care. A key strength of this study was its use of hospital cost data rather than charges. Future research should consider the longitudinal post-hospitalization costs of this approach to sTBI care. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 56 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 56 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 6 | 11% |
| Student > Ph. D. Student | 5 | 9% |
| Student > Master | 5 | 9% |
| Student > Bachelor | 5 | 9% |
| Student > Doctoral Student | 4 | 7% |
| Other | 10 | 18% |
| Unknown | 21 | 38% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 13 | 23% |
| Nursing and Health Professions | 8 | 14% |
| Psychology | 5 | 9% |
| Neuroscience | 3 | 5% |
| Immunology and Microbiology | 1 | 2% |
| Other | 5 | 9% |
| Unknown | 21 | 38% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 February 2018.
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#14,964,325
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Outputs from BMC Health Services Research
#5,429
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#256,712
of 443,072 outputs
Outputs of similar age from BMC Health Services Research
#127
of 160 outputs
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