Modeling healthcare demands and long-term costs following pediatric traumatic brain injury

IntroductionTraumatic brain injury (TBI) is a leading cause of death and disability in children, but data on the longitudinal healthcare and financial needs of pediatric patients is limited in scope and duration. We sought to describe and predict these metrics following acute inpatient treatment for...

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Main Authors: Jared G. Wiegand, Zorays Moazzam, Bruno P. Braga, Sarah E. Messiah, Faisal G. Qureshi
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-11-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2024.1385100/full
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author Jared G. Wiegand
Zorays Moazzam
Bruno P. Braga
Bruno P. Braga
Sarah E. Messiah
Sarah E. Messiah
Sarah E. Messiah
Faisal G. Qureshi
Faisal G. Qureshi
author_facet Jared G. Wiegand
Zorays Moazzam
Bruno P. Braga
Bruno P. Braga
Sarah E. Messiah
Sarah E. Messiah
Sarah E. Messiah
Faisal G. Qureshi
Faisal G. Qureshi
author_sort Jared G. Wiegand
collection DOAJ
description IntroductionTraumatic brain injury (TBI) is a leading cause of death and disability in children, but data on the longitudinal healthcare and financial needs of pediatric patients is limited in scope and duration. We sought to describe and predict these metrics following acute inpatient treatment for TBI.MethodsChildren surviving their initial inpatient treatment for TBI were identified from Optum’s deidentified Clinformatics® Data Mart Database (2007-2018). Treatment cost, healthcare utilization, and future inpatient readmission were stratified by follow-up intervals, type of claim, and injury severity. Both TBI-related and non-TBI related future cost and healthcare utilization were explored using linear mixed models. Acute inpatient healthcare utilization metrics were analyzed and used to predict future treatment cost and healthcare demands using linear regression models.ResultsAmong 7,400 patients, the majority suffered a mild TBI (50.2%). For patients with at least one-year follow-up (67.7%), patients accrued an average of 28.7 claims and $27,199 in costs, with 693 (13.8%) readmitted for TBI or non-TBI related causes. Severe TBI patients had a greater likelihood of readmission. Initial hospitalization length of stay and discharge disposition other than home were significant positive predictors of healthcare and financial utilization at one-and five-years follow-up. Linear mixed models demonstrated that pediatric TBI patients would accrue 21.1 claims and $25,203 in cost in the first year, and 9.4 claims and $4,147 in costs every additional year, with no significant differences based on initial injury severity.DiscussionPediatric TBI patients require long-term healthcare and financial resources regardless of injury severity. Our cumulative findings provide essential information to clinicians, caretakers, researchers, advocates, and policymakers to better shape standards, expectations, and management of care following TBI.
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spelling doaj-art-c6cd22a5a20040dca0c4578f79d017f52025-08-20T02:48:53ZengFrontiers Media S.A.Frontiers in Neurology1664-22952024-11-011510.3389/fneur.2024.13851001385100Modeling healthcare demands and long-term costs following pediatric traumatic brain injuryJared G. Wiegand0Zorays Moazzam1Bruno P. Braga2Bruno P. Braga3Sarah E. Messiah4Sarah E. Messiah5Sarah E. Messiah6Faisal G. Qureshi7Faisal G. Qureshi8School of Public Health, University of Texas Health Science Center, Dallas, TX, United StatesDepartment of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United StatesChildren’s Health System of Texas, Dallas, TX, United StatesDivision of Pediatric Neurosurgery, Department of Neurosurgery, UT Southwestern Medical Center, Dallas, TX, United StatesSchool of Public Health, University of Texas Health Science Center, Dallas, TX, United StatesCenter for Pediatric Population Health, UTHealth School of Public Health, Dallas, TX, United StatesDepartment of Pediatrics, McGovern Medical School, Houston, TX, United StatesChildren’s Health System of Texas, Dallas, TX, United StatesDivision of Pediatric Surgery, Department of Surgery, UT Southwestern Medical Center, Dallas, TX, United StatesIntroductionTraumatic brain injury (TBI) is a leading cause of death and disability in children, but data on the longitudinal healthcare and financial needs of pediatric patients is limited in scope and duration. We sought to describe and predict these metrics following acute inpatient treatment for TBI.MethodsChildren surviving their initial inpatient treatment for TBI were identified from Optum’s deidentified Clinformatics® Data Mart Database (2007-2018). Treatment cost, healthcare utilization, and future inpatient readmission were stratified by follow-up intervals, type of claim, and injury severity. Both TBI-related and non-TBI related future cost and healthcare utilization were explored using linear mixed models. Acute inpatient healthcare utilization metrics were analyzed and used to predict future treatment cost and healthcare demands using linear regression models.ResultsAmong 7,400 patients, the majority suffered a mild TBI (50.2%). For patients with at least one-year follow-up (67.7%), patients accrued an average of 28.7 claims and $27,199 in costs, with 693 (13.8%) readmitted for TBI or non-TBI related causes. Severe TBI patients had a greater likelihood of readmission. Initial hospitalization length of stay and discharge disposition other than home were significant positive predictors of healthcare and financial utilization at one-and five-years follow-up. Linear mixed models demonstrated that pediatric TBI patients would accrue 21.1 claims and $25,203 in cost in the first year, and 9.4 claims and $4,147 in costs every additional year, with no significant differences based on initial injury severity.DiscussionPediatric TBI patients require long-term healthcare and financial resources regardless of injury severity. Our cumulative findings provide essential information to clinicians, caretakers, researchers, advocates, and policymakers to better shape standards, expectations, and management of care following TBI.https://www.frontiersin.org/articles/10.3389/fneur.2024.1385100/fulltraumatic brain injuryfuture treatment costfuture caremedical claims datainjury severitypediatric
spellingShingle Jared G. Wiegand
Zorays Moazzam
Bruno P. Braga
Bruno P. Braga
Sarah E. Messiah
Sarah E. Messiah
Sarah E. Messiah
Faisal G. Qureshi
Faisal G. Qureshi
Modeling healthcare demands and long-term costs following pediatric traumatic brain injury
Frontiers in Neurology
traumatic brain injury
future treatment cost
future care
medical claims data
injury severity
pediatric
title Modeling healthcare demands and long-term costs following pediatric traumatic brain injury
title_full Modeling healthcare demands and long-term costs following pediatric traumatic brain injury
title_fullStr Modeling healthcare demands and long-term costs following pediatric traumatic brain injury
title_full_unstemmed Modeling healthcare demands and long-term costs following pediatric traumatic brain injury
title_short Modeling healthcare demands and long-term costs following pediatric traumatic brain injury
title_sort modeling healthcare demands and long term costs following pediatric traumatic brain injury
topic traumatic brain injury
future treatment cost
future care
medical claims data
injury severity
pediatric
url https://www.frontiersin.org/articles/10.3389/fneur.2024.1385100/full
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