Rais, Umar Mohd and Marret, Mary J. and Azzeri, Amirah (2024) Abusive head trauma: Annual medical costs for inpatient care of children managed at a single tertiary care centre in Malaysia. Child Abuse & Neglect, 158. p. 107126. ISSN 0145-2134, DOI https://doi.org/10.1016/j.chiabu.2024.107126.
Full text not available from this repository.Abstract
Background: Abusive head trauma (AHT) is a leading cause of traumatic head injury in young children. This study estimated the annual direct medical cost of managing AHT at a single tertiary care centre in Malaysia. Methods: Criteria were set for categorisation of patients as moderate or severe based on resource utilisation. The two methods used for cost computation were (1) cost estimation based on predefined clinical pathways for case management (2) computation of actual costs using patient-level data from retrospective review of all AHT admissions in 2021. Both methods utilised a combination of activity-based and top-down costing according to availability of reference data. Costs are presented in USD. Results: Costs for 9 severe and 3 moderate cases in 2021 amounted to $70,532.16, of which 93 % was for severe cases. Cost estimate for moderate cases was $2009.88 while actual costs ranged between $749.37-3115.47 (median $1422.76). Cost estimates of $15,125.76-$17,958.18 for severe cases exceeded actual costs of $2195.57-$13,186.03 (median $7379.40) for severe cases due to shorter-than-expected duration of stay, with only 2 who underwent neurosurgical procedures. Major cost contributors were duration of stay, intensive care, ventilation and neurosurgical procedures. Conclusion: Cost comparison utilising predefined treatment standards versus actual patient data which reveals major cost determinants enables refinement of budget allocation. Median medical costs for severe cases which exceeded the monthly income ceilings of low- and middle-income households in Malaysia demonstrate the economic burden of AHT, reinforcing the need to invest in prevention.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | Abusive head trauma; Child maltreatment; Economic analysis; Economic burden |
| Subjects: | B Philosophy. Psychology. Religion > BF Psychology R Medicine > RJ Pediatrics R Medicine > RZ Other systems of medicine |
| Divisions: | Faculty of Medicine > Paediatrics Department Universiti Malaya Medical Centre (UMMC) |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 19 Feb 2025 02:42 |
| Last Modified: | 19 Feb 2025 02:42 |
| URI: | http://eprints.um.edu.my/id/eprint/47351 |
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