Trends of paediatric head injury and acute care costs in Australia

Abstract

Aim Paediatric head injuries (PHI) are the most common cause of trauma‐related emergency department (ED) presentations. This study sought to report the incidence of PHI in Australia, examine the temporal trends from 2014 to 2018 and estimate the patient and population‐level acute care costs. Methods Taking a public‐sector health‐care perspective, we applied direct and indirect hospital costs for PHI‐related ED visits and acute admissions. All costs were inflated to 2018 Australian dollars ($). The patient‐level analysis was performed with data from 17 841 children <18 years old enrolled in the prospective Australasian Paediatric Head Injury Study. Mechanisms of injury were characterised by the total and average acute care costs. The population‐level data of PHI‐related ED presentations were obtained from the Independent Hospital Pricing Authority. Age‐standardised incidence rates (IR) and incidence rate ratios (IRR) were calculated, and negative binomial regression examined the temporal trend. Results The age‐standardised IR for PHI was 2734 per 100 000 population in 2018, with a significant increase over 5 years (IRR 1.13, 95% confidence interval (CI) 1.12–1.14; P < 0.001) and acute care costs of $154 million. Falls occurred in 70% of the study cohort, with average costs per episode of $666 (95% CI: $627–$706), accounting for 47% of acute care costs. Transportation‐related injuries occurred in 4.1% of the study cohort, with average costs per episode of $8555 (95% CI: $6193–$10 917), accounting for 35% of acute care costs. Conclusion PHI have increased significantly in Australia and are associated with substantial acute care costs. Population‐based efforts are required for road safety and injury prevention.

Cost-effectiveness of patient observation on cranial CT use with minor head trauma

“…Taking an Australian public-funded healthcare perspective, with an acute care time horizon, we applied direct and indirect hospital costs from a single paediatric site to patient-level data 2. Acute care included ED services and acute admissions 15…”

“…We applied direct and indirect costs sourced from the Royal Children’s Hospital (RCH) and prior publications (online supplemental appendix 2) to the patient-level data in the analytic cohort 2 17. Individual-level costing data for ED, and acute admissions were retrospectively obtained using the International Classification of Diseases 10th revision-Australian Modification codes identified for the patients enrolled in the APHIRST study (S00-S16and T20).…”

“…Direct ED costs were based on cubicle minutes, including doctor, nursing, triage and consumables. The indirect costs accounted for approximately 20%–25% of each unit’s operating expenses, including human resources, administrative staff and finance 2…”

“…Emergency department (ED) visits for minor blunt head trauma in children are common and increasing in the USA and Australia 1 2. The current neuroimaging modality recommended for diagnosing acute traumatic brain injury (TBI) is cranial CT 3.…”

Sports-related traumatic brain injuries and acute care costs in children

“…Sports were the second most common mechanism of injury in a cohort of approximately 18 000 Australian children presenting to ED with head injuries. 7 …”