Estimating the Economic Burden of Abusive Head Trauma in Children in North Carolina
Public Deposited- Last Modified
- January 27, 2020
- Creator
-
Pointer, Ivy
- Affiliation: Gillings School of Global Public Health, Public Health Leadership Program
- Abstract
- Introduction: Abusive head trauma causes significant morbidity and mortality in the pediatric population. Information on the economic burden of this condition is limited, making it difficult to determine how much funding to direct toward prevention. The Period of PURPLE Crying® is a promising abusive head trauma prevention program in the state of North Carolina. By collecting cost data on abusive head trauma victims and comparing it to the cost of the prevention program, the objective of this study is to demonstrate cost savings and suggest potential policy changes nationwide. Methods: Using ICD-9 codes, we identified all children less than 3 years old admitted to the North Carolina Children’s Hospital Pediatric Intensive Care Unit with traumatic brain injury between 2005 and 2010. Demographic data (age, gender, year, payer type), hospital and physician charges, length of stay, intensive care unit days, and ventilator days were collected on each patient. Charges were further divided into pharmaceutical, laboratory, blood product transfusion, and radiology charges. The cases were classified as abusive head trauma and accidental head trauma based on the CDC recommendations for determining abuse from ICD-9 codes. The mean cost of hospitalization per patient was calculated for each group. The cost of the prevention program per patient was calculated. Results: 74 cases were identified with 27 cases of abusive head trauma and 47 cases of accidental head trauma or unknown etiology. The mean charges for hospitalization of abusive head trauma victims were $99,970 with a median of $64,643. The mean charges for the accidental head trauma group were significantly less at $46,406. This difference was statistically significant in the 25th and 50th quartiles. There were also significant differences between the two groups in length of stay, PICU days, and ventilator days. The cost of the Period of PURPLE Crying® program is $3.93 per infant exposed. Conclusion: The charges of hospitalizing abusive head trauma victims average nearly $100,000, significantly higher than the cost of caring for children with head trauma from other causes. For the charges associated with one abusive head trauma admission, 25,000 infants can be exposed to the Period of PURPLE Crying®. Preventing at least 6 cases per year would make this program cost effective. This program demonstrates the potential to provide significant costs savings through prevention.
- Date of publication
- August 2011
- DOI
- Resource type
- Rights statement
- In Copyright
- Note
- Paper type: Research or research design
- Track: HC&P
- Advisor
- Tolleson-Rinehart, Sue
- Degree
- Master of Public Health
- Degree granting institution
- University of North Carolina at Chapel Hill
- Graduation year
- 2011
- Language
- Deposit record
- b6f6bdeb-f0b9-4907-a2ad-769b5d2e1080
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