Aggressive Versus Routine Care Of TBI-Which Is More Cost Effective?

The economic burden of a moderate to severe traumatic brain injury (TBI) is substantial. Aggressive medical procedures such as a decompressive craniectomy or invasive intracranial monitoring add further expense, and may not always contribute to a positive outcome. Past research about the cost-effectiveness of aggressive procedures after a TBI has been mixed.

However, a recent study found that, when compared to routine care of TBI, aggressive care is significantly cost-effective. Despite the higher initial cost of aggressive care, it results in a lower lifetime cost than routine care. Aggressive care was shown to be cost-effective across all age groups, including those over age 80. Routine care that primarily relies on providing comfort is associated with a poorer outcome and greater lifetime cost. Comfort care should be reserved for those who are clearly beyond the benefit of more aggressive treatment.

Whitmore RG, Thawani JP, Grady MS, et al. Is aggressive treatment of traumatic brain injury cost-effective? Journal of Neurosurgery. (March 2012).

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