Burden of USA hospital charges for traumatic brain injury.

The study reports billed charges, not actual costs, amounts reimbursed, or final amounts paid by patients or insurers. It used hospital billing records, so it lacked many clinical details, and injury severity was estimated from diagnosis codes rather than direct clinical assessment. TBI visits were identified by ICD-9-CM codes, and coding accuracy and consistency may vary across hospitals. A TBI code could have been carried over from a previous encounter, although 70% of TBI-related visits had a TBI code as the primary diagnosis. Total charges were missing for 0.5% of admissions and 14.9% of discharge or transfer visits and were imputed. The analysis excluded federal hospitals and nonhospital visits, so it underestimates the total charge burden for TBI. It did not include indirect costs such as care after discharge, cognitive and emotional costs, or lost wages. It did not convert charges to costs; prior work cited suggests approximately 42% of emergency department charges are paid, but that is not the study's own conversion. It reports hospital charges, not clinical outcomes.

The article is listed as supported by NIH extramural research funding. The authors declared no conflicts of interest for the remaining authors.

Do not read these amounts as what patients, insurers, or hospitals actually paid. The study reports billed charges for entire visits, not costs, reimbursements, or TBI-specific charges, and it cannot show which services drove the charges.