Published online August 1, 2006
PEDIATRICS Vol. 118 No. 2 August 2006, pp. 483-492 (doi:10.1542/peds.2005-2588)
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ARTICLE

Incidence of Pediatric Traumatic Brain Injury and Associated Hospital Resource Utilization in the United States

Andrew J. Schneier, BAa, Brenda J. Shields, MSa, Sarah Grim Hostetler, BAa, Huiyun Xiang, MD, MPH, PhDa,b and Gary A. Smith, MD, DrPHa,b

a Center for Injury Research and Policy, Columbus Children's Research Institute, Children's Hospital, Columbus, Ohio
b Department of Pediatrics, Ohio State University College of Medicine and Public Health, Columbus, Ohio

OBJECTIVE. The goal was to examine the influence of sociodemographic characteristics and health care system factors on the utilization of hospital resources by US children ≤17 years of age with a diagnosis of traumatic brain injury.

METHODS. A retrospective analysis of data from the Healthcare Cost and Utilization Project Kids' Inpatient Database, from January 1, 2000, to December 31, 2000, was performed. National estimates of traumatic brain injury-associated hospitalization rates and resource use were calculated with Kids' Inpatient Database sample weighting methods.

RESULTS. Of 2516833 encounters between January 1, 2000, and December 31, 2000, 25783 cases involved patients ≤17 years of age with a recorded diagnosis of traumatic brain injury. On the basis of these data, there were an estimated 50658 traumatic brain injury-associated hospitalizations among children ≤17 years of age in the United States in 2000. The traumatic brain injury-associated hospitalization rate was 70 cases per 100000 children ≤17 years of age per year; 15- to 17-year-old patients had the highest hospitalization rate (125 cases per 100000 children per year). Pediatric inpatients accrued more than $1 billion in total charges for traumatic brain injury-associated hospitalizations in this study. In the multivariate regression models, older age, Medicaid insurance status, and admission to any type of children's hospital were associated with a longer length of stay for pediatric traumatic brain injury-associated hospitalizations. Older age, longer length of stay, and in-hospital death predicted higher total charges for traumatic brain injury-associated hospitalizations.

CONCLUSION. Pediatric traumatic brain injury is a substantial contributor to the health resource burden in the United States, accounting for more than $1 billion in total hospital charges annually.

Key Words: traumatic brain injury • pediatrics • resource utilization • length of stay • total charges • Kids' Inpatient Database

Abbreviations: CDC—Centers for Disease Control and Prevention • CI—confidence interval • KID—Kids' Inpatient Database • LOS—length of stay • OLS—ordinary least-squares • TBI—traumatic brain injury

Accepted Mar 2, 2006.




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