Acute costs and predictors of higher treatment costs for major paediatric trauma in <scp>N</scp>ew <scp>S</scp>outh <scp>W</scp>ales, <scp>A</scp>ustralia

Mitchell, Robert J.; Curtis, Kate; Holland, A.J.A.; Balogh, Zsolt J.; Evans, Julie; Wilson, Kellie L.

doi:10.1111/jpc.12280

Cited by 11 publications

(9 citation statements)

References 28 publications

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“…Falls and road trauma accounted for 33% and 22% of acute care costs, respectively. Further, they reported children 1–5 years had the highest total costs; however, infants had the highest average cost for major paediatric trauma 19 . We report the cost of acute admissions for 4361 children was $13 million, with 46% from transportation‐related injuries, followed by 39% from falls.…”

Section: Discussionmentioning

confidence: 83%

Trends of paediatric head injury and acute care costs in Australia

Singh

Babl

Hearps

et al. 2021

J Paediatrics Child Health

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Aim Paediatric head injuries (PHI) are the most common cause of trauma‐related emergency department (ED) presentations. This study sought to report the incidence of PHI in Australia, examine the temporal trends from 2014 to 2018 and estimate the patient and population‐level acute care costs. Methods Taking a public‐sector health‐care perspective, we applied direct and indirect hospital costs for PHI‐related ED visits and acute admissions. All costs were inflated to 2018 Australian dollars ($). The patient‐level analysis was performed with data from 17 841 children <18 years old enrolled in the prospective Australasian Paediatric Head Injury Study. Mechanisms of injury were characterised by the total and average acute care costs. The population‐level data of PHI‐related ED presentations were obtained from the Independent Hospital Pricing Authority. Age‐standardised incidence rates (IR) and incidence rate ratios (IRR) were calculated, and negative binomial regression examined the temporal trend. Results The age‐standardised IR for PHI was 2734 per 100 000 population in 2018, with a significant increase over 5 years (IRR 1.13, 95% confidence interval (CI) 1.12–1.14; P < 0.001) and acute care costs of $154 million. Falls occurred in 70% of the study cohort, with average costs per episode of $666 (95% CI: $627–$706), accounting for 47% of acute care costs. Transportation‐related injuries occurred in 4.1% of the study cohort, with average costs per episode of $8555 (95% CI: $6193–$10 917), accounting for 35% of acute care costs. Conclusion PHI have increased significantly in Australia and are associated with substantial acute care costs. Population‐based efforts are required for road safety and injury prevention.

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Section: Discussionmentioning

confidence: 83%

Trends of paediatric head injury and acute care costs in Australia

Singh

Babl

Hearps

et al. 2021

J Paediatrics Child Health

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“…This is particularly true in this study as SCN and NICU admissions were reported together, with admission to NICU distinguished in the cost analysis by use of mechanical ventilation. There is also evidence that average cost funding by peer group, such as HRGs or AR‐DRGs, underestimates the actual costs incurred by the hospital for paediatric intensive care . Micro‐costing of intensive care costs applies more patient‐specific costs; however, this method requires a great detail of data collection .…”

Section: Discussionmentioning

confidence: 99%

An economic evaluation of planned immediate versus delayed birth for preterm prelabour rupture of membranes: findings from the PPROMT randomised controlled trial

Lain

Roberts

Bond

et al. 2016

BJOG

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Objective This study is an economic evaluation of immediate birth compared with expectant management in women with preterm prelabour rupture of the membranes near term (PPROMT).Design A cost-effectiveness analysis alongside the PPROMT randomised controlled trial.Setting Obstetric departments in 65 hospitals across 11 countries.Population Women with a singleton pregnancy with ruptured membranes between 34 +0 and 36 +6 weeks gestation.Methods Women were randomly allocated to immediate birth or expectant management. Costs to the health system were identified and valued. National hospital costing data from both the UK and Australia were used. Average cost per recruit in each arm was calculated and 95% confidence intervals were estimated using bootstrap re-sampling. Averages costs during antenatal care, delivery and postnatal care, and by country were estimated.Main outcomes measures Total mean cost difference between immediate birth and expectant management arms of the trial.Results From 11 countries 923 women were randomised to immediate birth and 912 were randomised to expectant management. Total mean costs per recruit were £8852 for immediate birth and £8740 for expectant delivery resulting in a mean difference in costs of £112 (95% CI: À431 to 662). The expectant management arm had significantly higher antenatal costs, whereas the immediate birth arm had significantly higher delivery and neonatal costs. There was large variation between total mean costs by country.Conclusion This economic evaluation found no evidence that expectant management was more or less costly than immediate birth. Outpatient management may offer opportunities for cost savings for those women with delayed delivery.Keywords Cost-benefit analysis, delivery, fetal membranes, intensive care, neonatal/economics, neonatal sepsis, obstetric, premature birth/*prevention and control, premature rupture.Tweetable abstract For women with preterm prelabour rupture of the membranes, the relative benefits and harms of immediate and expectant management should inform counselling as costs are similar.

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“…Drowning disproportionately impacts young children where the greatest health losses are attributed. Drowning attracts the highest economic burden with respect to paediatric trauma treatment costs 52 and high mortality risk within 30 days of hospitalisation for paediatric patients when compared to other injury mechanisms 53 . Across the general population, drowning is also a preventable cause of public health‐related harm.…”

Section: Implications For Public Healthmentioning

confidence: 99%

Analysis of fatal unintentional drowning in Australia 2008–2020: implications for the Australian Water Safety Strategy

Peden

Scarr²,

Mahony³

2021

Australian and New Zealand Journal of Public Health

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The AWSC developed the first National Water Safety Plan (NWSP) in 1998 with a stated purpose of fostering cooperation and commitment in the fight against drowning. 9 The NWSP 1998 focused on: water safety research; management of aquatic locations; water safety education; and the targeting of key drowning demographics. This plan was updated in 2004 10 following further research and workshops with key stakeholders.In 2008, the Plan was replaced by the AWSS, which proposed an aspirational target of reducing drowning deaths by 50% by 2020. 11 This target was intended as a focal point for advocacy, as well as being an indicator that flowed through a new drowning prevention framework. This framework was structured in three priority areas: 'life stages' -an acknowledgement that drowning risk changes throughout the life course; 'key locations' -which allowed for a more traditional lifesaving approach and focus on risk management and other strategies specific

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Acute costs and predictors of higher treatment costs for major paediatric trauma in New South Wales, Australia

Abstract: The high financial cost of paediatric patient treatment highlights the need to ensure prevention remains a priority in Australia. Hospitals tasked with providing trauma care should be appropriately funded and future funding models should consider trauma severity.

Cited by 11 publications

References 28 publications

Trends of paediatric head injury and acute care costs in Australia

Trends of paediatric head injury and acute care costs in Australia

An economic evaluation of planned immediate versus delayed birth for preterm prelabour rupture of membranes: findings from the PPROMT randomised controlled trial

Analysis of fatal unintentional drowning in Australia 2008–2020: implications for the Australian Water Safety Strategy

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