title: Healthcare costs associated with mild traumatic brain injury and psychological distress in children and adolescents.
abstract: OBJECTIVE
  Comparison of healthcare costs for youth with mild traumatic brain injuries (TBIs) to costs in a matched cohort of children without TBI in the 3 years following injury.
  
  
  METHODS
  This study used a prospective cohort design with 3-year follow-up. Costs were examined using the well-established two-step model and controlling for potential confounding variables.
  
  
  METHODS
  Four-hundred and ninety subjects from a large health maintenance organization, 14 years old or younger, who sustained a mild TBI in 1993, were identified using computerized records. For each youth with mild TBI, three control subjects were selected (n = 1470), matched on age, sex and enrolment at the time of injury.
  
  
  METHODS
  Not applicable.
  
  
  RESULTS
  TBI exposure was associated with an increase in the proportion of subjects who had non-zero medical costs in all categories examined and a 75% increase in mean total costs. Presence of psychological distress was also associated with increased proportion of subjects with costs in all categories examined and was associated with an approximate doubling of mean total costs.
  
  
  CONCLUSIONS
  Mild TBI and psychological distress were each associated with significant increases in healthcare costs in an HMO setting.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195-6560, USA. rockhill@u.washington.edu
authors.forename: Carol M
authors.initials: CM
authors.lastname: Rockhill
authors.forename: Jesse R
authors.initials: JR
authors.lastname: Fann
authors.forename: Ming-Yu
authors.initials: MY
authors.lastname: Fan
authors.forename: William
authors.initials: W
authors.lastname: Hollingworth
authors.forename: Wayne J
authors.initials: WJ
authors.lastname: Katon
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000150:complications / Q000191:economics* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005190:Family; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D013315:Stress, Psychological / Q000150:complications / Q000191:economics* / Q000523:psychology