gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

The financial outcome of traumatic brain injury: a single centre study

Meeting Abstract

  • Daniel M. Fountain - University of Cambridge, Addenbrooke’s Hospital, Division of Neurosurgery, Cambridge, United Kingdom
  • Angelos G. Kolias - University of Cambridge, Addenbrooke’s Hospital, Division of Neurosurgery, Cambridge, United Kingdom
  • Rodney J. Laing - University of Cambridge, Addenbrooke’s Hospital, Division of Neurosurgery, Cambridge, United Kingdom
  • Peter J. Hutchinson - University of Cambridge, Addenbrooke’s Hospital, Division of Neurosurgery, Cambridge, United Kingdom

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMO.11.06

doi: 10.3205/17dgnc061, urn:nbn:de:0183-17dgnc0610

Published: June 9, 2017

© 2017 Fountain et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives: Severe traumatic brain injury (TBI) is a potentially devastating insult to the brain with high rates of fatality and neurological deficits. Evidence suggests TBI can result in substantial costs to the centre providing care, but there is an absence of data on financial outcome. We sought to present the experience of a Major Trauma Centre (MTC) in the United Kingdom and ascertain the financial implications of this healthcare provision, in particular detailed costs, reimbursement and the surplus or deficit accrued by the centre.

Methods: All cranial non-elective neurosurgical admissions with a TBI over 4.5 months (26th October 2014 to 15th March 2015) were analysed retrospectively, excluding cases of chronic subdural haematoma, at an MTC in England. Clinical and demographic data were collected alongside detailed cost and income data.

Results: Ninety-four patients were identified. The majority of patients presented with more than one diagnosis of cranial trauma. Average length of stay was 18.8±21.6 days. Total deficits as a result of treating this cohort amounted to £558,034. There was a significant association between (i) more complex presentations and (ii) a longer length of stay and the deficit accrued by the centre. The major drivers of the financial outcome were costs associated with wards, medical staffing and overheads.

Conclusion: There was a substantial deficit accrued as a result of the management of patients with TBI at an MTC. The more complex the presentation, extensive the intervention, and lengthy the stay, the greater the deficit accrued by the centre. The tariff payment system in the United Kingdom is not currently effectively reflecting the severity of injury or intensity of management of patients with TBI.