Health and economic burden of traumatic brain injury: Missouri, 2001-2005.

OBJECTIVE We examined the financial and social costs resulting from traumatic brain injury (TBI) in Missouri. METHODS We computed mortality rates from death certificates, the direct cost of TBI from hospital and emergency department (ED) visit charges, the social cost in terms of years of potential life lost (YPLL) using an abridged Missouri life table, and the indirect financial cost in terms of lost productivity due to premature death for all TBI and four major causes of TBI in Missouri. RESULTS During 2001-2005, a mean of 1358 lives were lost due to TBI in Missouri. Four major causes-unintentional falls, motor vehicle traffic crashes, motorcycle crashes, and firearms-accounted for 88% of all TBI deaths. We estimated the annual direct medical cost of TBI at $95 million, or about $1.67 million per 100,000 Missourians. This cost increased by about 60% between 2001 and 2005. The four major causes of TBI accounted for 68% of all direct medical costs of TBI. We estimated the cost per hospitalization and ED visit at $6948 and the indirect social cost at 48,501 YPLL. During this period, the mean age of TBI fatality was 44 years. We determined the lost productivity due to TBI mortality--$1.1 billion, or about $18.8 million per 100,000 Missourians--to be three times as high for males as for females. CONCLUSIONS The types of costs covered in this study underestimated the total cost of TBI in Missouri, as we did not include outpatient care, rehabilitation, and drug costs. Nevertheless, we found the health and economic burden from medical care and mortality related to TBI to be substantial in Missouri.