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October 28, 2014; 83 (18) Article

Cost of traumatic brain injury in New Zealand

Evidence from a population-based study

Braden Te Ao, Paul Brown, Martin Tobias, Shanthi Ameratunga, Suzanne Barker-Collo, Alice Theadom, Kathryn McPherson, Nicola Starkey, Anthony Dowell, Kelly Jones, Valery L. Feigin
First published September 26, 2014, DOI: https://doi.org/10.1212/WNL.0000000000000933
Braden Te Ao
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
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Paul Brown
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
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Martin Tobias
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
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Shanthi Ameratunga
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
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Suzanne Barker-Collo
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
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Alice Theadom
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
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Kathryn McPherson
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
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Nicola Starkey
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
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Anthony Dowell
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
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Kelly Jones
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
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Valery L. Feigin
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
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Citation
Cost of traumatic brain injury in New Zealand
Evidence from a population-based study
Braden Te Ao, Paul Brown, Martin Tobias, Shanthi Ameratunga, Suzanne Barker-Collo, Alice Theadom, Kathryn McPherson, Nicola Starkey, Anthony Dowell, Kelly Jones, Valery L. Feigin
Neurology Oct 2014, 83 (18) 1645-1652; DOI: 10.1212/WNL.0000000000000933

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Abstract

Objective: We aimed to estimate from a societal perspective the 1-year and lifetime direct and indirect costs of traumatic brain injury (TBI) for New Zealand (NZ) in 2010 projected to 2020.

Methods: An incidence-based cost of illness model was developed using data from the Brain Injury Outcomes New Zealand in the Community Study. Details of TBI-related resource use during the first 12 months after injury were obtained for 725 cases using resource utilization information from participant surveys and medical records. Total costs are presented in US dollars year 2010 value.

Results: In 2010, 11,301 first-ever TBI cases were estimated to have occurred in NZ; total first-year cost of all new TBI cases was estimated to be US $47.9 million with total prevalence costs of US $101.4 million. The average cost per new TBI case during the first 12 months and over a lifetime was US $5,922 (95% confidence interval [CI] $4,777–$7,858), varying from US $4,636 (95% CI $3,756–$5,561) for mild cases to US $36,648 (95% CI $16,348–$65,350) for moderate/severe cases. Because of the unexpectedly large number of mild TBI cases (95% of all TBI cases), the total cost of treating these cases is nearly 3 times that of moderate/severe. The total lifetime cost of all TBI survivors in 2010 was US $146.5 million and is expected to increase to US $177.1 million in 2020.

Conclusion: The results suggest that there is an urgent need to develop effective interventions to prevent both mild and moderate/severe TBI.

GLOSSARY

BIONIC=
Brain Injury Outcomes New Zealand in the Community;
CI=
confidence interval;
GCS=
Glasgow Coma Scale;
ICD-10=
International Classification of Diseases, tenth revision;
MOH=
Ministry of Health;
NMDS=
National Minimum Dataset;
NZ=
New Zealand;
TBI=
traumatic brain injury;
WIES=
Weighted Inlier Equivalent Separations

Footnotes

  • BIONIC Study Group coinvestigators are listed on the Neurology® Web site at Neurology.org.

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at Neurology.org

  • Received March 1, 2014.
  • Accepted in final form July 29, 2014.
  • © 2014 American Academy of Neurology
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Letters: Rapid online correspondence

  • BURDEN OF TRAUMATIC BRAIN INJURY:INDIAN SCENARIO
    • Khichar Purnaram Shubhakaran, Associate Professor Neurology, Department of Neurology, Dr. S. N. Medical Colege, Jodhpur, Indiadrkhicharsk@gmail.com
    Submitted November 10, 2014
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