Estimated Life-Time Savings in the Cost of Ongoing Care Following Specialist Rehabilitation for Severe Traumatic Brain Injury in the United Kingdom. J Head Tr Rehab, 2019 August
NPsych Pick of the Month – September:
Estimated Life-Time Savings in the Cost of Ongoing Care Following Specialist Rehabilitation for Severe Traumatic Brain Injury in the United Kingdom
Turner-Stokes, Lynne; Dzingina, Mendwas; Shavelle, Robert; et al. Section Editor(s): Caplan, Bruce; Bogner, Jennifer; et al.
The Journal of Head Trauma Rehabilitation: July/August 2019 – Volume 34 – Issue 4 – p 205–214
https://doi.org/10.1097/HTR.0000000000000473
Objectives: To evaluate cost-efficiency of rehabilitation following severe traumatic brain injury (TBI) and estimate
the life-time savings in costs of care. Setting/Participants: TBI patients (n = 3578/6043) admitted to all 75 specialist
rehabilitation services in England 2010–2018. Design: A multicenter cohort analysis of prospectively collated
clinical data from the UK Rehabilitation Outcomes Collaborative national clinical database. Main Measures:
Primary outcomes: (a) reduction in dependency (UK Functional Assessment Measure), (b) cost-efficiency, measured
in time taken to offset rehabilitation costs by savings in costs of ongoing care estimated by the Northwick Park
Dependency Scale/Care Needs Assessment (NPDS/NPCNA), and (c) estimated life-time savings. Results: The mean
age was 49 years (74% males). Including patients who remained in persistent vegetative state on discharge, the mean
episode cost of rehabilitation was £42 894 (95% CI: £41 512, £44 235), which was offset within 18.2 months by
NPCNA-estimated savings in ongoing care costs. The mean period life expectancy adjusted for TBI severity was 21.6
years, giving mean net life-time savings in care costs of £679 776/patient (95% CI: £635 972, £722 786). Conclusions:
Specialist rehabilitation proved highly cost-efficient for severely disabled patients with TBI, despite their reduced
life-span, potentially generating over £4 billion savings in the cost of ongoing care for this 8-year national cohort.
