Primary prevention of pediatric abusive head trauma: a cost audit and cost-utility analysis.

نویسندگان

  • Joshua Friedman
  • Peter Reed
  • Peter Sharplin
  • Patrick Kelly
چکیده

OBJECTIVES To obtain comprehensive, reliable data on the direct cost of pediatric abusive head trauma in New Zealand, and to use this data to evaluate the possible cost-benefit of a national primary prevention program. METHODS A 5 year cohort of infants with abusive head trauma admitted to hospital in Auckland, New Zealand was reviewed. We determined the direct costs of hospital care (from hospital and Ministry of Health financial records), community rehabilitation (from the Accident Compensation Corporation), special education (from the Ministry of Education), investigation and child protection (from the Police and Child Protective Services), criminal trials (from the Police, prosecution and defence), punishment of offenders (from the Department of Corrections) and life-time care for moderate or severe disability (from the Accident Compensation Corporation). Analysis of the possible cost-utility of a national primary prevention program was undertaken, using the costs established in our cohort, recent New Zealand national data on the incidence of pediatric abusive head trauma, international data on quality of life after head trauma, and published international literature on prevention programs. RESULTS There were 52 cases of abusive head trauma in the sample. Hospital costs totaled $NZ2,433,340, child protection $NZ1,560,123, police investigation $NZ1,842,237, criminal trials $NZ3,214,020, punishment of offenders $NZ4,411,852 and community rehabilitation $NZ2,895,848. Projected education costs for disabled survivors were $NZ2,452,148, and the cost of projected lifetime care was $NZ33,624,297. Total costs were $NZ52,433,864, averaging $NZ1,008,344 per child. Cost-utility analysis resulted in a strongly positive economic argument for primary prevention, with expected case scenarios showing lowered net costs with improved health outcomes. CONCLUSIONS Pediatric abusive head trauma is very expensive, and on a conservative estimate the costs of acute hospitalization represent no more than 4% of lifetime direct costs. If shaken baby prevention programs are effective, there is likely to be a strong economic argument for their implementation. This study also provides robust data for future cost-benefit analysis in the field of abusive head trauma prevention.

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منابع مشابه

Pediatric Abusive Head Trauma

Pediatric abusive head trauma – once commonly known as the shaken baby syndrome – is a form of child abuse that results in traumatic brain injury. The peak incidence of pediatric abusive head trauma appears to be in children between the ages of 2 to 4 months; the exact incidence of this injury is not known. Pediatric abusive head trauma often results in severe and permanent neurological damage,...

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عنوان ژورنال:
  • Child abuse & neglect

دوره 36 11-12  شماره 

صفحات  -

تاریخ انتشار 2012