Evidence map›Paper›PMID 29329548›Full record

ArticleBMC health services research2018

The cost of a pediatric neurocritical care program for traumatic brain injury: a retrospective cohort study.

Steven W Howard, Zidong Zhang, Paula Buchanan, Stephanie L Bernell, Christine Williams, Lindsey Pearson, Michael Huetsch, Jeff Gill, Jose A Pineda

Abstract read
In one paragraph

Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Cost of pediatric traumatic brain injury in developing countries: a retrospective cohort study.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025
    Article
  2. Resveratrol Attenuates Cognitive Deficits of Traumatic Brain Injury by Activating p38 Signaling in the Brain.Medical science monitor : international medical journal of experimental and clinical research · 2018
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Steven W HowardSaint Louis University, Health Management and Policy, Salus Center 374, 3545 Lafayette Ave., St. Louis, MO, 63104, USA. Steven.Howard@SLU.edu.ORCID 0000-0002-6390-5945
Zidong ZhangSaint Louis University, School of Medicine, St. Louis, MO, USA.
Paula BuchananSaint Louis University, Center for Outcomes Research, St. Louis, MO, USA.
Stephanie L BernellOregon State University, School of Social and Behavioral Health Sciences, Corvallis, OR, USA.
Christine WilliamsUnited Healthcare, Minneapolis, MN, USA.
Lindsey PearsonSt. Luke's Health System, Kansas City, MO, USA.
Michael HuetschGoldfarb School of Nursing at Barnes-Jewish College, St. Louis, MO, USA.
Jeff GillDivision of Biostatistics, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA.
Jose A PinedaWashington University in St. Louis, School of Medicine, St. Louis, MO, USA.

Funding

St. Louis Children's Hospital Foundation n/a
6 · The paper itself

Abstract

backgroundInpatient care for children with severe traumatic brain injury (sTBI) is expensive, with inpatient charges averaging over $70,000 per case (Hospital Inpatient, Children Only, National Statistics. Diagnoses- clinical classification software (CCS) principal diagnosis category 85 coma, stupor, and brain damage, and 233 intracranial injury. Diagnoses by Aggregate charges [ https://hcupnet.ahrq.gov/#setup ]). This ranks sTBI in the top quartile of pediatric conditions with the greatest inpatient costs (Hospital Inpatient, Children Only, National Statistics. Diagnoses- clinical classification software (CCS) principal diagnosis category 85 coma, stupor, and brain damage, and 233 intracranial injury. Diagnoses by Aggregate charges [ https://hcupnet.ahrq.gov/#setup ]). The Brain Trauma Foundation developed sTBI intensive care guidelines in 2003, with revisions in 2012 (Kochanek, Carney, et. al. PCCM 3:S1-S2, 2012). These guidelines have been widely disseminated, and are associated with improved health outcomes (Pineda, Leonard. et. al. LN 12:45-52, 2013), yet research on the cost of associated hospital care is limited. The objective of this study was to assess the costs of providing hospital care to sTBI patients through a guideline-based Pediatric Neurocritical Care Program (PNCP) implemented at St. Louis Children's Hospital, a pediatric academic medical center in the Midwest United States.

methodsThis is a retrospective cohort study. We used multi-level regression to estimate pre-/post-implementation effects of the PNCP program on inflation adjusted total cost of in-hospital sTBI care. The study population included 58 pediatric patient discharges in the pre-PNCP implementation group (July 15, 1999 - September 17, 2005), and 59 post-implementation patient discharges (September 18, 2005 - January 15, 2012).

resultsImplementation of the PNCP was associated with a non-significant difference in the cost of care between the pre- and post-implementation periods (e

conclusionsImplementation of the PNCP to support delivery of guideline-based care for children with sTBI did not change the total per-patient cost of in-hospital care. A key strength of this study was its use of hospital cost data rather than charges. Future research should consider the longitudinal post-hospitalization costs of this approach to sTBI care.

Indexed as

Hospital CostsIntensive Care Units, PediatricAdolescentBrain Injuries, TraumaticChildChild, PreschoolFemaleGuidelines as TopicHospitalizationHumansInfantInjury Severity ScoreMaleProgram EvaluationRetrospective StudiesUnited StatesChild healthCost of careGuidelinesNeurocritical careTraumatic brain injury

Identifiers

PMID29329548
PMCPMC5766987

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.