The economic burden of traumatic brain injury at Pietersburg Hospital, Limpopo Province: a retrospective micro-costing study

Abstract

Background: Trauma cost studies have been limited in low-to middle-income countries (LMICs). The aim of the study was to calculate economic costs resulting from major trauma in those with brain injuries.

Methods: This is a retrospective study of patients who sustained a traumatic brain injury (TBI) and injury severity score (ISS) >16 treated at Pietersburg Hospital in a 2-year period (January 2019 to December 2020). Theatre registers were used as starting point for data collection. Additional data was obtained from ICU and the neurosurgical ward. Data analysis utilised dual methods with both micro-costing and grossing models.

Results: The review identified 83 patients. The most common mechanism of injury was assault with a blunt object (54.2%), followed by motor vehicle collisions (MVC) (16.9%). The mean length of stay for ICU admissions was 14 days, while ward admissions were 9.2 days. The most common diagnosis on CT scan was epidural haematoma with or without skull fracture (51.8%), followed by isolated skull fracture (21.8%). The average cost per admission was R572 925.00 for ICU patients and R244 503.00 for the ward stay.

Conclusion: The most common cause of TBI was assault. The cost of treating a patient with TBI was higher than in most studies and exceeded R50 000 per patient per day.