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dc.contributor.authorFountain, Daniel Men
dc.contributor.authorKolias, Angelosen
dc.contributor.authorLaing, Rodney Jen
dc.contributor.authorHutchinson, Peteren
dc.date.accessioned2016-11-21T15:52:12Z
dc.date.available2016-11-21T15:52:12Z
dc.date.issued2016-10-22en
dc.identifier.issn0268-8697
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/261242
dc.description.abstract$\textbf{Objectives}$: Severe traumatic brain injury (TBI) is a potentially devastating insult to the brain with high rates of fatality and neurological deficits. TBI can result in substantial costs to the centre providing care. We sought to present the experience of a Major Trauma Centre (MTC) and ascertain the financial implications of this healthcare provision, in particular detailed costs, reimbursement and the surplus or deficit accrued by the centre. $\textbf{Design}$: All cranial non-elective neurosurgical admissions with a TBI over 4.5 months (26 October 2014 to 15 March 2015) were analysed retrospectively, excluding cases of chronic subdural haematoma, at an MTC in England. Demographic data were collected alongside detailed cost and income data. $\textbf{Results}$: Ninety four patients were identified. The majority of patients presented with more than one diagnosis of cranial trauma. Average length of stay was 18.8 ± 21.6 days. Total deficits as a result of treating this cohort amounted to £558,034. There was a significant association between (i) more complex presentations and (ii) a longer length of stay and the deficit accrued by the centre. The major drivers of the financial outcome were costs associated with wards, medical staffing and overheads. $\textbf{Conclusion}$: There was a substantial deficit accrued as a result of the management of patients with TBI at an MTC. The more complex the presentation, extensive the intervention, and lengthy the stay, the greater the deficit accrued by the centre. The current tariff payment system is not effectively reflecting the severity of injury or intensity of management of patients with TBI.
dc.description.sponsorshipPJH is supported by a NIHR Research Professorship and the NIHR Cambridge Biomedical Research Centre.
dc.languageEnglishen
dc.language.isoenen
dc.publisherTaylor & Francis
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjecttraumatic brain injuryen
dc.subjecttariffsen
dc.subjectcostsen
dc.subjectcost-analysisen
dc.subjectservice improvementen
dc.titleThe financial outcome of traumatic brain injury: a single centre studyen
dc.typeArticle
dc.description.versionThis is the author accepted manuscript. The final version is available from Taylor & Francis via https://doi.org/10.1080/02688697.2016.1244254en
prism.publicationDate2016en
prism.publicationNameBritish Journal of Neurosurgeryen
dc.identifier.doi10.17863/CAM.6413
dcterms.dateAccepted2016-09-25en
rioxxterms.versionofrecord10.1080/02688697.2016.1244254en
rioxxterms.versionVoRen
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2016-10-22en
dc.contributor.orcidKolias, Angelos [0000-0003-3992-0587]
dc.contributor.orcidHutchinson, Peter [0000-0002-2796-1835]
dc.identifier.eissn1360-046X
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idNIHR Evaluation, Trials and Studies Coordinating Centre (NETSCC) (HTA/12/35/57)
pubs.funder-project-idNIHR Evaluation, Trials and Studies Coordinating Centre (NETSCC) (HTA/13/15/02)
pubs.funder-project-idTCC (NIHR-RP-R3-12-013)
rioxxterms.freetoread.startdate2017-10-22


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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International