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Concussion a disproportionate health care cost to society

janessa-gravesSPOKANE, Wash. – Traumatic brain injuries (TBI) in children are costly to individuals and society. A new study shows that, though moderate and severe TBI cost more for the individuals involved, there are so many more cases of mild TBI, such as concussions, that their cost to the general population is much higher.

The study is important because it provides evidence that mild TBI prevention strategies could lead to significant cost savings, said lead author Janessa Graves, assistant professor in the College of Nursing at Washington State University, who did the research with the University of Washington’s Harborview Injury Prevention and Research Center (HIPRC).

“Mild TBI cannot be thought of as a low-cost or short-term problem,” she said. “The study demonstrates that concussion costs account for a disproportionate cost burden at the macro level.”

The study was published Aug. 13 in the American Journal of Public Health (

The study found that children with concussions and other mild TBIs, despite being up to 11 times less expensive to treat, accounted for nearly 81 percent of the $1.59 billion in health care costs for pediatric TBIs in the first year. These cases accounted for 96.6 percent of the roughly 600,000 patients in the study.

While previous studies describe the costs associated with pediatric TBI, they focused on limited geographic areas or immediate costs following injuries. Most research on pediatric TBI costs have focused on more severe cases.

“No study has looked at a sample this large and over the long term,” said co-author Monica Vavilala, HIPRC director. “We aimed to capture data from the largest possible sample and over the time period where the majority of associated costs occur.”

The study used a commercial insurance claims database, to which nearly half of U.S. health insurers contribute data, to provide a comprehensive estimate of total health care costs.

“This was the first study to our knowledge to provide data on all-cause health care costs after pediatric TBI in a large, commercially insured population across the spectrum of TBI severity,” the authors wrote.



Janessa Graves, WSU College of Nursing, 509-324-7257,



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