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Research paper
Cost prediction following traumatic brain injury: model development and validation
  1. Gershon Spitz1,2,
  2. Dean McKenzie3,4,
  3. David Attwood5,
  4. Jennie L Ponsford1,2
  1. 1School of Psychological Sciences, Monash University, Melbourne, Australia
  2. 2Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, Australia
  3. 3Clinical Trials and Research Centre, Epworth Healthcare, Melbourne, Australia
  4. 4School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
  5. 5Transport Accident Commission, Geelong, Australia
  1. Correspondence to Gershon Spitz, School of Psychological Sciences, Monash University, Clayton VIC 3800, Australia; Gershon.Spitz{at}


Objective The ability to predict costs following a traumatic brain injury (TBI) would assist in planning treatment and support services by healthcare providers, insurers and other agencies. The objective of the current study was to develop predictive models of hospital, medical, paramedical, and long-term care (LTC) costs for the first 10 years following a TBI.

Methods The sample comprised 798 participants with TBI, the majority of whom were male and aged between 15 and 34 at time of injury. Costing information was obtained for hospital, medical, paramedical, and LTC costs up to 10 years postinjury. Demographic and injury-severity variables were collected at the time of admission to the rehabilitation hospital.

Results Duration of PTA was the most important single predictor for each cost type. The final models predicted 44% of hospital costs, 26% of medical costs, 23% of paramedical costs, and 34% of LTC costs. Greater costs were incurred, depending on cost type, for individuals with longer PTA duration, obtaining a limb or chest injury, a lower GCS score, older age at injury, not being married or defacto prior to injury, living in metropolitan areas, and those reporting premorbid excessive or problem alcohol use.

Conclusions This study has provided a comprehensive analysis of factors predicting various types of costs following TBI, with the combination of injury-related and demographic variables predicting 23-44% of costs. PTA duration was the strongest predictor across all cost categories. These factors may be used for the planning and case management of individuals following TBI.


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