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ANNUAL ACUTE HOSPITAL COST OF PAEDIATRIC HEAD INJURY IN AUSTRALIA – A PAEDIATRIC RESEARCH IN EMERGENCY DEPARTMENTS INTERNATIONAL COLLABORATIVE (PREDICT) STUDY
  1. JA Cheek1,2,
  2. M Lyttle1,2,
  3. E Oakley1,2,
  4. F Babl1,2,
  5. M Borland3,12,
  6. K Dalziel4,
  7. GN Kanal4,
  8. N Phillips5,
  9. Y Gilhotra5,
  10. A Kochar6,
  11. S Dalton7,
  12. M McCaskill7,
  13. J Furyk8,
  14. J Neutze9,
  15. SR Dalziel10,11
  1. 1Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia
  2. 2Murdoch Children's Research Institute, Melbourne, Victoria, Australia
  3. 3Emergency Department, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
  4. 4Center for Health Policy, University of Melbourne, Melbourne, Victoria, Australia
  5. 5Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
  6. 6Women's & Children's Hospital, Adelaide, South Australia, Australia
  7. 7The Children's Hospital at Westmead, Sydney, New South Wales, Australia
  8. 8The Townsville Hospital, Townsville, Queensland, Australia
  9. 9Kidzfirst Middlemore Hospital, Auckland, New zealand
  10. 10Emergency Department, Starship Children's Hospital, Auckland, New zealand
  11. 11Liggins institute, University of Auckland, Auckland, New zealand
  12. 12University of Western Australia, Perth, Western Australia, Australia

Abstract

Objectives & Background Children with head injuries (HIs) frequently present to acute care settings. Most injuries are mild, but a small portion of patients have clinically significant intracranial injuries. An attempt to estimate the cost of paediatric HIs using prospectively collected data has never been attempted in Australia. We aimed to estimate the total cost paediatric HI in Australia and provide an understanding of the costs associated with different causative and presentation factors.

Methods The study was embedded in a prospective observational study of 20,255 children <18 years designed to validate three published clinical decision rules. Each patient's hospital presentation was micro-costed and then extrapolated to an annualised Australia-wide figure using Australian Independent Hospital Pricing Authority data.

Results There were 109,729 cases of HI in children aged 0–18 years across Australia in the fiscal year 2012–2013 (1.67% of total emergency presentations). The average cost of each HI was $1348.21 [95%CI: 1173.02 to 1523.40]. The total cost of HI in Australia was $147.94 million [95% CI: 128.71 to 167.17]. Regression and generalized linear models both demonstrate that motor vehicle accidents (MVAs) and non-accidental injury (NAI) are the most significant drivers of cost, as are injuries presenting with vomiting, seizure and loss of consciousness greater than 5 minutes.

Conclusion Paediatric head injury represents a significant cost to the Australian healthcare system. Efforts to reduce the main drivers of cost–MVAs and NAI – may reduce this.

  • Trauma

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