PW 1804 Using cost to measure the burden of infant abusive head trauma in british columbia, canada

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Abstract

Although the incidence of abusive head trauma (AHT) among infants aged 0 to 24 months is low, the health consequences can be severe and long lasting. Survivors of AHT may experience physical, neurologic and behavioural impairments which are costly to the victim, their family, the health care system as well as society at large.

The aim of this study was to calculate the broad economic and societal burden of infant AHT using a conservative incidence costing, human capital societal approach. Cases of AHT were identified through a comprehensive, evidence-based, chart review process with the Child Protection Services Team – comprised of emergency physicians, nurses and social workers – that documents all referred child protection cases for the province of British Columbia (BC), Canada.

Length of stay and hospital resource allocation for each case was obtained from the Discharge Abstract Database obtained from the Canadian Institute of Health Information. Disability weights were applied to estimate costs of disability and health loss. Direct costs for mortality were estimated using average costs for a complete episode of events due to an AHT death. Loss of productivity was calculated to obtain indirect costs. Further, the study computes the Return on Investment (ROI) of implementing a province-wide program to prevent the incidence of infant AHT.

Based on the estimated total costs of infant AHT and the cost of the prevention program, a 2% reduction in the annual incidence of AHT would result in a positive ROI and net saving to government and society. Due to the considerable individual, family and societal costs, implementation of well-developed parental education programs as a component of AHT prevention are appropriate, and cost beneficial.

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