期刊
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE
卷 63, 期 6, 页码 1271-1278出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/TA.0b013e3181493080
关键词
cost benefit; traumatic brain injury; TBI; treatment guidelines; acute care; societal impact; rehabilitation; Glasgow Outcome Score
Background: A decade after promulgation of treatment guidelines by the Brain Trauma Foundation (BTF), few studies exist that examine the application of these guidelines for severe traumatic brain injury TBI) patients. These studies have reported both cost savings and reduced mortality. Materials: We projected the results of previous studies of BTF guideline adoption to estimate the impact of widespread adoption across the United States. We used surveillance systems and national surveys to estimate the number of severely injured TBI patients and compared the lifetime costs of BTF adoption to the current state of treatment. Results: After examining the health outcomes and costs, we estimated that a substantial savings in annual medical costs ($262 million), annual rehabilitation costs ($43 million) and lifetime societal costs ($3.84 billion) would be achieved if treatment guidelines were used more routinely. Implementation costs were estimated to be $61 million. The net savings were primarily because of better health outcomes and a decreased burden on lifetime social support systems. We also estimate that mortality would be reduced by 3,607 lives if the guidelines were followed. Conclusions: Widespread adoption of the BTF guidelines for the treatment of severe TBI would result in substantial savings in costs and lives. The majority of cost savings are societal costs. Further validation work to identify the most effective aspects of the BTF guidelines is warranted.
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