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Journal of Child and Family Studies

, Volume 27, Issue 3, pp 750–755 | Cite as

A Cost Analysis of a Validated Screening Tool for Pediatric Abusive Head Trauma

  • Austin C. Cohrs
  • Edeanya Agbese
  • Douglas L. Leslie
  • Kent P. Hymel
Original Paper
  • 383 Downloads

Abstract

Doctors who treat young victims of trauma are required to make important decisions to launch or forgo child abuse evaluations in their acutely head-injured patients. To improve the accuracy of these decisions, Pediatric Brain Injury Research Network (PediBIRN) investigators derived and validated a 4-variable clinical prediction rule (CPR) that improves the detection of abusive head trauma (AHT) in pediatric intensive care units. Our objective was to estimate and compare medical costs from the health system perspective of AHT screening guided by the CPR vs. screening as usual (SAU). Cost estimates for child abuse evaluations, emergency department (ED)/pediatrician visits, and hospital admissions for AHT were combined with published data on service use and re-injury rates in children with missed or unrecognized AHT. Applying published estimates of the CPR’s potential screening performance, the cost per correctly identified child with AHT was calculated and compared for AHT screening guided by the CPR vs. SAU, and the potential medical cost savings associated with CPR application was estimated. Applied accurately and consistently, the CPR could reduce the cost per correctly identified child with AHT by 15.1%, and reduce health system costs resulting from missed AHT by 72.4%.

Keywords

Cost analysis Abusive head trauma Child abuse Clinical prediction rule Screening test 

Notes

Funding

This study was internally funded.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no competing interests.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.The Center for Applied Studies in Health Economics (CASHE), Department of Public Health SciencesPennsylvania State University College of MedicineHersheyUSA
  2. 2.Department of PediatricsPennsylvania State University College of MedicineHersheyUSA

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