title: Characteristics of acute treatment costs of traumatic brain injury in Eastern China--a multi-centre prospective observational study.
abstract: BACKGROUND
  This study investigated acute treatment costs and related factors for traumatic brain injuries (TBI) in eastern China based on a prospective multicentre study.
  
  
  METHODS
  Data were prospectively collected from 80 hospitals in eastern China by standardized structured questionnaires during 2004. Included patients were admitted to hospitals via an emergency service with a diagnosis of TBI. The total acute hospitalization treatment costs derived from unsubsidized total hospital billings were used as the main outcome measure. Univariate and multivariable regression models were used to examine factors associated with each outcome.
  
  
  RESULTS
  In total, 13,007 TBI cases were identified from 80 hospitals in eastern China. The median cost per hospitalization was $879 US (range, $72-45,894). The median cost per day was $79 (interquartile range, $49-126). The hospitalization costs varied based on the cause of TBI, with a median of $1017 for traffic accidents, $816 for falls, $490 for blows to the head, and $712 for falls. The hospitalization costs also varied by injury type with a mean of $918 for TBI associated with other injuries and $831 for isolated TBI. Using multiple regression analyses, lower admission Glasgow Coma score, longer hospital stay (LOS), male sex, transient patient status, traffic accident, injury occurring on a construction site, treatment at a tertiary hospital, neurosurgical intensive care unit (NICU) or ICU stay, associated polytrauma, and those who needed a neurosurgical operation had significantly higher total acute hospitalization costs than those of other groups. Good recovery and self-paying patients had lower total costs. A double LOS was associated with a 1.61 (95% confidence interval, 1.59-1.62) times higher hospital cost.
  
  
  CONCLUSIONS
  Our results have potential implications for health-care resource planning during TBI treatment. Measures to prevent traffic accidents and reduce the LOS may help to reduce acute hospitalization costs.
authors.affiliation: Department of Neurosurgery, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China. 297260090@qq.com
authors.forename: Qiang
authors.initials: Q
authors.lastname: Yuan
authors.forename: Hua
authors.initials: H
authors.lastname: Liu
authors.forename: Xing
authors.initials: X
authors.lastname: Wu
authors.forename: Yirui
authors.initials: Y
authors.lastname: Sun
authors.forename: Haijun
authors.initials: H
authors.lastname: Yao
authors.forename: Liangfu
authors.initials: L
authors.lastname: Zhou
authors.forename: Jin
authors.initials: J
authors.lastname: Hu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D017281:Cost of Illness; D004636:Emergency Service, Hospital; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D015601:Injury Severity Score; D007362:Intensive Care Units / Q000191:economics*; D007902:Length of Stay / Q000191:economics*; D008297:Male; D008875:Middle Aged; D011050:Policy Making; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult