期刊
JOURNAL OF PAEDIATRICS AND CHILD HEALTH
卷 58, 期 2, 页码 274-280出版社
WILEY
DOI: 10.1111/jpc.15699
关键词
Australia; Craniocerebral Trauma; emergency medicine; Hospital Costs
类别
资金
- National Health and Medical Research Council (Centre of Research Excellence for Paediatric Emergency Medicine), Canberra, Australia [GNT1046727, GNT1058560]
- Murdoch Children's Research Institute, Melbourne, Australia
- Emergency Medicine Foundation, Brisbane, Australia [EMPJ-11162]
- Perpetual Philanthropic Services, Australia [2012/1140]
- Auckland Medical Research Foundation, Auckland, New Zealand [3112011]
- A+Trust (Auckland District Health Board), Auckland, New Zealand
- WA Health Targeted Research Funds 2013, Perth, Australia
- Townsville Hospital and Health Service Private Practice Research and Education Trust Fund, Townsville, Australia
- Victorian Government's Infrastructure Support Program, Melbourne, Australia
- Australian Government Research Training Program Scholarship
- PREDICT CRE Research Higher Degree scholarship
- Royal Children's Hospital Foundation
- Melbourne Campus Clinician Scientist Fellowship, Melbourne, Australia
- NHMRC Practitioner Fellowship, Canberra, Australia
The incidence of paediatric head injuries in Australia has significantly increased over the past five years, with acute care costs reaching $154 million. Falls are the most common mechanism of injury, accounting for 47% of acute care costs, followed by transportation-related injuries at 35%. Population-based efforts for road safety and injury prevention are crucial.
Aim Paediatric head injuries (PHI) are the most common cause of trauma-related emergency department (ED) presentations. This study sought to report the incidence of PHI in Australia, examine the temporal trends from 2014 to 2018 and estimate the patient and population-level acute care costs. Methods Taking a public-sector health-care perspective, we applied direct and indirect hospital costs for PHI-related ED visits and acute admissions. All costs were inflated to 2018 Australian dollars ($). 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.
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