Background
Methods
Study population
I. Traumatic Causes | |
---|---|
Diagnosis | ICD-10 Code and Description |
1. Fracture of the skull | S02.0 Skull |
S02.1 Base of skull | |
S02.9 Skull and facial bones S02.7 Multiple fractures involving skull and facial bones | |
S02.89 Fractures of other unspecified skull and facial bones | |
2. Intracranial Injury excluding those with skull fracture | S06.0 Concussion |
S06.2 Diffuse brain injury | |
S06.4 – Epidural Hemorrhage | |
S06.5 – Traumatic subdural hemorrhage | |
S06.6 – Traumatic subarachnoid hemorrhage | |
S06.8 – Other intracranial injuries | |
S06.1 – Traumatic cerebral edema | |
S06.3 – Focal brain injury | |
S06.9 – Intracranial injury unspecified | |
S09.7 – Multiple injuries of head | |
S09.8 – Other unspecified injuries of head | |
S09.9 – Unspecified injury of head | |
3. Other causes including late effects of injuries poisonings toxic effects & other external causes | T90.2 – Sequelae of fracture of skull and facial bones |
T90.5 – Sequelae of intracranial injury | |
T90.8 - Sequelae of other specified injuries of head | |
T90.9 – Sequelae of unspecified injury of head | |
T96 – Sequelae of poisoning by drugs medicaments and biological substances | |
T97 – Sequelae of toxic effects of substances chiefly nonmedicinal as to source | |
T98.2 – Sequelae of certain early complications of trauma | |
II. Non Traumatic Causes
| |
Diagnosis
|
ICD-10 Code and Description
|
1. Toxic effects of substances chiefly non-medical as to source | T51– Toxic effect of alcohol |
T56 – Toxic effect of metals | |
T58– Toxic effect of carbon monoxide | |
2. Complications of surgical & medical care not elsewhere classified | G93.8 Other specified disorders of the brain (including post-radiation encephalopathy) |
3. Anoxia | G93.1– Anoxic brain damage (includes all causes of anoxia except those occurring following abortions ectopic pregnancy labour & delivery & newborn) |
T75.1– Drowning and nonfatal submersion | |
T71– Asphyxiation suffocation (by strangulation) | |
4. Vascular insults | I62.0 – Subdural hemorrhage |
(Aneurysm and vascular malformations) | I62.9 – Unspecified intracranial hemorrhage |
RVL Needs clarification | |
Aneurysm I77.0 | |
Malformation Q28.0 –Q28.9 | |
Traumatic aneurysm T14.5 | |
5. Brain Tumours | C71 – Malignant neoplasm of brain |
C79.3 – Secondary malignant neoplasm of brain and cerebral meninges | |
D33.0-D33.3 – Benign neoplasm of brain and other parts of central nervous system | |
D32.0 – Benign neoplasm of cerebral meninges | |
D43 – Neoplasm of uncertain or unknown behaviour of brain and central nervous system | |
C70 – Malignant neoplasm of brain | |
D43.2 – Neoplasm of brain unspecified | |
D42.0 - Neoplasm of uncertain or unknown behaviour of cerebral meninges | |
6. Encephalitis | A81.1– Subacute sclerosing encephalitis |
B00.4 – Herpesviral meningoencephalitis | |
B05.0 – Postmeasles encephalitis | |
A83.0 – Japanese encephalitis | |
A83.2 – Eastern equine encephalitis | |
A86.0 – Unspecified viral encephalitis | |
G04.0 – Acute Disseminated encephalitis | |
G04.8 – Other encephalitis myelitis and encephalomyelitis | |
G04.9 – Encephalitis myelitis and encephalomyelitis unspecified | |
B01.1 – Varicella encephalitis | |
B02.0 – Zoster encephalitis | |
G05. – Encephalitis myelitis and encephalomyelitis in diseases classified elsewhere | |
7. Metabolic Encephalopathies | E10.0 (Type I) E11.0 (Type II) |
E13.0 – Other specified diabetes mellitus with coma | |
E14.0 – Unspecified diabetes mellitus with coma | |
E15 – Nondiabetic hypoglycaemic coma | |
F07.2 – post concussion syndrome | |
8. Meningitis | G06.0 – intracranial abscess and granuloma |
G06.1 – Intraspinal abscess and granuloma G06.2 – Extradural and subdural abscess unspecified | |
G93.0 – Cerebral cysts | |
A87 – Viral meningitis | |
B01.0 – Varicella meningitis | |
B37.5 – Candidal meningitis | |
G00 – Bacterial meningitis not elsewhere classified | |
G01* – Meningitis in bacterial diseases classified elsewhere | |
G02* – Meningitis in other infectious and parasitic diseases classified elsewhere | |
G03. – Meningitis due to other and unspecified causes |
Overview of cost calculation
ED visits and acute care
Complex continuing care
Inpatient rehabilitation
Home care
Ambulatory care
Privacy and ethics
Results
Discharged to Rehab [N (%)] | Not discharged to Rehab [N (%)] | Total [N (%)] | |
---|---|---|---|
Sex | |||
Female | 403 (34) | 3717 (34) | 4120 (34) |
Male | 784 (66) | 7066 (66) | 7850 (66) |
Age | |||
<18 | 21 (2) | 2460 (23) | 2481 (21) |
18-34 | 262 (22) | 1891 (18) | 2153 (18) |
35-54 | 306 (26) | 2114 (20) | 2420 (20) |
55-64 | 144 (12) | 1040 (10) | 1184 (10) |
65-74 | 133 (11) | 1061 (10) | 1194 (10) |
75+ | 321 (27) | 2217 (21) | 2538 (21) |
Residence | |||
Non-Rural | 1016 (86) | 8570 (80) | 9586 (80) |
Rural | 171 (14) | 2213 (20) | 2384 (20) |
Charlson Comorbidity Index | |||
0-1 | 1035 (87) | 10018 (93) | 11053 (92) |
2-3 | 132 (11) | 615 (6) | 747 (6) |
4+ | 20 (2) | 150 (1) | 170 (1) |
Inpatient LOS (days) | |||
1-2 | 5 (0) | 2760 (25) | 2765 (23) |
3-5 | 56 (5) | 2099 (29) | 3155 (26) |
6-11 | 224 (19) | 2451 (23) | 2675 (22) |
12+ | 902 (76) | 2473 (23) | 3375 (28) |
Motor Vehicle Related | |||
Yes | 416 (35) | 2099 (20) | 2515 (21) |
No | 771 (65) | 8684 (80) | 9455 (79) |
TBI category* | |||
Fracture of Skull | 440 (37) | 3257 (30) | 3697 (30) |
Intercranial Injury | 1098 (92) | 8916 (82) | 10014 (83) |
Other causes | 30 (2) | 670 (6) | 700 (5) |
Discharged to Rehab [N (%)] | Not discharged to Rehab [N (%)] | Total [N (%)] | |
---|---|---|---|
Sex | |||
Female | 1308 (47) | 13741 (48) | 15049 (48) |
Male | 1496 (53) | 14956 (52) | 16452 (52) |
Age | |||
<18 | 10 (0) | 2450 (9) | 2460 (8) |
18-34 | 106 (4) | 2235 (8) | 2341 (7) |
35-54 | 485 (17) | 6056 (21) | 6541 (21) |
55-64 | 450 (16) | 4519 (16) | 4969 (16) |
65-74 | 644 (23) | 5298 (18) | 5942 (19) |
75+ | 1109 (40) | 8129 (28) | 9248 (29) |
Residence | |||
Non-Rural | 2444 (87) | 23856 (83) | 26300 (84) |
Rural | 360 (13) | 4841 (17) | 5201 (16) |
Charlson Comorbidity Index | |||
0-1 | 1445 (52) | 14675 (51) | 16120 (51) |
2-3 | 904 (32) | 6885 (24) | 7789 (25) |
4+ | 455 (16) | 7137 (25) | 7582 (24) |
Inpatient LOS (days) | |||
1-2 | 24 (1) | 2911 (10) | 2935 (9) |
3-5 | 168 (6) | 6943 (24) | 7111 (23) |
6-11 | 584 (21) | 8148 (28) | 8732 (28) |
12+ | 2028 (72) | 10695 (37) | 12723 (40) |
Type of nTBI* | |||
Brain Infection | 274 (10) | 4023 (14) | 4297 (14) |
Brain Tumour | 1888 (67) | 17172 (60) | 19060 (60) |
Metabolic encephalopathies | 109 (3) | 2086 (7) | 2195 (7) |
Anoxia | 121 (4) | 902 (3) | 1023 (3) |
Complications of Surgical and Medical Care | 74 (3) | 754 (3) | 828 (3) |
Vascular Insults | 358 (13) | 1065 (6) | 2423 (8) |
Toxic Effects | 12 (0) | 1918 (7) | 1930 (6) |
TBI | nTBI | |||||
---|---|---|---|---|---|---|
All TBI Pts. | DC to IR | Not DC to IR | All nTBI Pts. | DC to IR | Not DC to IR | |
Year 1 [N]
| [11970] | [1187] | [10783] | [31501] | [2804] | [28697] |
Mean Annual Cost (standard deviation) | Mean Annual Cost (standard deviation) | |||||
Emergency Department |
$187
|
$187
|
$187
|
$187
|
$187
|
$187
|
Acute Care |
$19083
|
$43123
|
$16436
|
$23078
|
$37953
|
$21625
|
(72495) | (43441) | (74538) | (77157) | (45451) | (79431) | |
Inpatient Rehabilitation |
$5363
|
$33646
|
$2250
|
$3149
|
$23610
|
$1150
|
(22191) | (43062) | (15649) | (13379) | (29211) | (8261) | |
Complex Continuing Care |
$3535
|
$8168
|
$3025
|
$5626
|
$11855
|
$5017
|
(28259) | (40179) | (26576) | (32105) | (49895) | (29734) | |
Homecare |
$722
|
$993
|
$692
|
$1626
|
$2104
|
$1580
|
(2259) | (2439) | (2236) | (3856) | (3793) | (3859) | |
Physician |
$3242
|
$7223
|
$2804
|
$4352
|
$6532
|
$4138
|
(5122) | (8152) | (4458) | (4251) | (4702) | (4143) | |
Annual Cost
|
$32132
|
$93340
|
$25394
|
$38018
|
$82241
|
$33697
|
Year 2 [N]
| [11294] | [1107] | [10187] | [23049] | [2372] | [20677] |
Emergency Department |
$3
|
$5
|
$3
|
$9
|
$8
|
$9
|
Acute Care |
$377
|
$462
|
$368
|
$787
|
$689
|
$798
|
(5434) | (3894) | (5573) | (6027) | (5855) | (6047) | |
Inpatient Rehabilitation |
$148
|
$464
|
$114
|
$127
|
$381
|
$98
|
(3720) | (5776) | (3428) | (2545) | (4664) | (2177) | |
Complex Continuing Care |
$606
|
$1219
|
$540
|
$1018
|
$2067
|
$898
|
(11297) | (18599) | (10192) | (13093) | (19010) | (12228) | |
Homecare |
$512
|
$892
|
$471
|
$1242
|
$1934
|
$1162
|
(2436) | (3705) | (2251) | (4146) | (5068) | (4019) | |
Physician |
$934
|
$1325
|
$892
|
$1515
|
$1790
|
$1483
|
(1607) | (1600) | (1602) | (2226) | (3076) | (2104) | |
Annual Cost
|
$2580
|
$4367
|
$2388
|
$4698
|
$6869
|
$4448
|
Year 3 [N]
| [9068] | [897] | [8171] | [17325] | [1799] | [15526] |
Emergency Department |
$1
|
$1
|
$1
|
$4
|
$4
|
$4
|
Acute Care |
$116
|
$287
|
$98
|
$263
|
$350
|
$254
|
(2542) | (4935) | (2154) | (2915) | (3482) | (2845) | |
Inpatient Rehabilitation |
$0
|
$0
|
$0
|
$83
|
$169
|
$74
|
(2056) | (2694) | (1971) | ||||
Complex Continuing Care |
$483
|
$344
|
$498
|
$1045
|
$2120
|
$922
|
(6698) | (3675) | (6944) | (12303) | (15052) | (11954) | |
Homecare |
$606
|
$1086
|
$555
|
$1378
|
$2305
|
$1271
|
(3695) | (4633) | (3573) | (5596) | (6520) | (5469) | |
Physician |
$1028
|
$1433
|
$984
|
$1625
|
$1901
|
$1593
|
(2315) | (5188) | (1744) | (2720) | (2751) | (2715) | |
Annual Cost
|
$2234
|
$3151
|
$2136
|
$4398
|
$4544
|
$2847
|