Table 1.

Cost studies

Study Title	Study Author(s)/Year	Findings	Type of Cost
Prevalence and Costs of Co-occurring Traumatic Brain Injury With and Without Psychiatric Disturbance and Pain Among Afghanistan and Iraq War Veteran VA Users.	Taylor et al., 2012	OEF/OIF Veterans with TBI in 2009 had 4 times higher median cost relative to those without TBI. Those with TBI and PTSD had higher median cost. The median annual cost per OEF/OIF Veteran diagnosed with TBI was $5,831 as compared to $1,547 for Veterans without TBI. Among Veterans with TBI, the median annual cost for those with TBI, PTSD and pain was $7,974.	Total VA health services costs for OEF/OIF Veterans with TBI, with and without comorbid PTSD.
Non-surgical Intervention and Cost for Mild Traumatic Brain Injury: Results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury	Borg et al., 2004	Review article of non-surgical intervention and mild TBI costs. Found indirect costs are much higher than direct medical costs. Admission and radiological policies are determining factors of direct costs.	Direct and Indirect Costs For Mild TBI.
Trend and Geographic Analysis for Traumatic Brain Injury Mortality and Cost Based on Market Scan Database	Hu et al., 2013	For 52,721 privately insured and 23,592 Medicare insured patients with TBI from 2004 to 2009, median hospital costs for adults were $13,000 for 18-64 and $9,000 for 65+. Significant differences in cost by geographic region were also found with the highest costs in California and Washington.	Privately insured and Medicare inpatient hospital costs.
Utilization and Costs of Health Care after Geriatric Traumatic Brain Injury	Thompson et al., 2012	Among adults aged 55-84 years old in the National Study on the Costs and Outcomes (NSCOT) database diagnosed with TBI, unadjusted mean costs ranged from $72,733 in the 75-84 group to $77,872 in the 55-64 group. In adjusted cost model, index hospitalization and inpatient rehabilitation costs were lowest among 75-84 while outpatient care and nursing home costs were lowest among younger ages.	Index hospitalization, inpatient, outpatient and nursing home costs for geriatric TBI.
The Direct Economic Burden of Blunt and Penetrating Trauma in a Managed Care Population	Davis KL et al., 2007	Initial hospitalization charges ranged from $32,627 for TBI alone to $103,667 for TBI along with other trauma. Initial hospitalization charges were highest for those admitted to Level 1 trauma centers except for TBI with other trauma while charges were highest for nontrauma centers.	Initial hospitalization charges for TBI with and without other trauma.
Mental Illness, Traumatic Brain Injury, and Medicaid Expenditures	Wei et al., 2005	Among a Medicaid population in four states, the presence of comorbid mental illness increased the cost of care for those with TBI. For those without severe mental illness (SMI) and TBI, total expenditures were $6,093 compared to $8,723 for those with TBI and an SMI in Alabama, $$6,919 vs. $13,688 for Georgia, $21,924 vs. $10,907 for New Jersey, and $7,154 vs. $19,986 for Wisconsin.	Medicaid cost for TBI with and without comorbid mental illness.
Outcomes and costs of acute treatment of traumatic brain injury	McGarry L et al., 2002	For patients aged 16 and older hospitalized for TBI between 1/1/97 and 6/20/1999, costs of hospitalization ranged from an average of $8,189 for moderate to $33,537 for critical TBI. Costs ranged from $15,860 for falls to $20,084 for gunshot wounds and 20,522 for motor vehicle accidents.	TBI inpatient hospital cost for moderate and critical TBI.
Charges and lengths of stay for acute and inpatient rehabilitation treatment of traumatic brain injury 1990-1996	Kreutzer et al., 2001	Over a 7 year period between 1990-1996, acute care daily charges showed almost routine increases while lengths of stay generally showed a downward trend with annual reductions averaging 2.25 days. The rise in rehabilitation charges was offset by corresponding decreases in lengths of stay. Increases in daily charges for rehabilitation were comparable to general medical care prices while rate of change in acute care charges was substantially greater, about 10% higher than medical care prices.	Length of stay utilization and charges for inpatient hospital and inpatient rehabilaition for TBI.
The Costs of Traumatic Brain Injury	Thompson K, 2001	Mean cost of treating a TBI at TBI Model System facilities were about $98,612 per case while the mean costs of inpatient rehabilitation were $43,212, not including physician charges.	Inpatient hospitalization and inpatient rehabilaition cost at TBI Model System Rehabiliation facilities for TBI.
Health Care Costs Associated with Traumatic Brain Injury and Psychiatric Illness in Adults	Rockhill et al., 2011	Average costs were 76% higher in the 3 years after injury for the mild TBI group and 5.75 times greater for moderate to severe TBI group when compared to controls. Presence of psychiatric illness associated with more than doubling of total costs for both inpatient and outpatient non-mental health care.	Inpatient and outpatient costs of TBI with and without comorbid psychiatric conditions.
Medical Care Costs Associated with Traumatic Brain Injury over the Full Spectrum of Disease: A Controlled Population-Based Study	Leibson et al., 2012	For incident TBI in the Rochester Epidemiology Project (REP) among residents of Olmsted Minnesota, most incremental costs occurred within the first 6 months while significant long-term incremental costs were not apparent among 1 year survivors. Cost differences between possible TBI cases and matched controls were not as great in the first 6 months, but were substantial among 1 year survivors.	Short and long-term incremental costs for 1 year survivors of TBI.
Health and Economic Burden of Traumatic Brain Injury: Missouri, 2001-2005	Kayani et al., 2009	During 2001-2005, mean cost per hospitalization and ED visit was approximately $6,948..	Inpatient hospitalization and emergency department costs for TBI.
The contribution of traumatic brain injury to the medical and economic outcomes of motor vehicle-related injuries in Ohio	Rochette LM et al., 2009	Among injured roadway users in Ohio between 2003 and 2006, when compared with a non-TBI injury, total hospital charges increased by a factor of 1.35 for a TBI. Mean hospital charges were $46,441 for a TBI roadway injury versus $32,614 for a non-TBI roadway injury.	Inpatient hospital charges for TBI and non-TBI roadway injuries.
Long-Term Medical Care Utilization and Costs Among Traumatic Brain Injury Survivors	Vangel SJ et al., 2005	Among 63 participants in Michigan, residential, home health and state case management billings accounted for 15% of total billing, nearly half of total charges and 27% of Medicaid payments. Medications accounted for 39% of total billings, 19% of Medicaid payments and 7% of charges. Outpatient services (excluding primary care program services) contributed 21% of total billings, 24% of total charges and 31% of Medicaid payments. Primary care accounted for 13% of billings, 4% of charges and 6% of Medicaid payments. Emergency room visits contributed 12% of billings, 8% of charges and 7% of Medicaid payments. Motor deficits (FIM score) at discharge from inpatient rehabilitation showed inverse relationship to billings	Long-term care costs for TBI.
Characteristics of acute treatment costs of traumatic brain injury in Eastern China-a mulit-centre prospective observational study	Yuan et al., 2012	Hospitalization costs were highest for traffic accidents and lowers for blows to the head. In adjusted analysis, lower Glasgow coma score, longer LOS, male sex, transient patient status. Traffic accident, injury occurring on a construction site, treatment at a tertiary hospital, neurosurgical ICU, ICU stay, polytrauma and those needing neurosurgery had significantly higher costs while good recovery and self-paying patients had lower costs. A double LOS was associated with a 1.6 times higher hospital cost.	Inpatient hospital costs of TBI in China.
The economic cost of brain disorders in Europe	Olesen et al., 2012	The latest estimate for the cost of TBI in Europe in 2010 was €2,697 in direct health care costs.	Direct costs of TBI in Europe.
Determinants of hospital costs associated with traumatic brain injury in England and Wales	Morris S et al., 2008	Mean costs per patient were highest in those with an Abbreviated Injury Scale (AIS) of 5. Length of stay in critical care accounted for 51% of mean total costs, regular ward 38% and travel costs 5%. Those aged 45-64 years had highest costs. Costs were highest among those injured in motor vehicle accidents, those with a lower Glascow coma score (GCS) and those with a higher AIS. Co-existing neck, thorax, abdomen and spine also increased costs. Surgery was associated with higher costs as was being seen in a hospital with a neurosurgical unit, being seen by a specialist from anesthesia, orthopedics, and general surgery. Mortality was associated with lower costs.	Inpatient hospital costs of TBI in England and Wales.
Economic evidence in trauma: a review	Berg J, 2004	Based on 2004 data, average inpatient cost for TBI in Germany was €2,529, compared with €2,833 in Spain and €3,024 in Sweden. Average inpatient cost for concussion was €1,071 for Germany, €987 for Spain, and €927 for Sweden. Average inpatient cost for severe brain injury was €6,647 for Germany, €6,362 for Spain and €6,045 for Sweden.	Inpatient hospital cost for TBI in Germany, Spain and Sweden.