Cost Effectiveness Analysis of Using Multiple Neuromodalities in Treating Severe Traumatic Brain Injury in a Developing Country Like Malaysia
OBJECTIVE: The aim of this study was to determine the cost-effectiveness of using baseline neuromonitoring (BNM) compared with multimodality monitoring (M3) for severe traumatic brain injury (TBI). METHODS: Sixty-two patients with severe TBI underwent a prospective observational study where they...
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Main Authors: | , , , , , |
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Format: | Article |
Published: |
Elsevier
2007
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Subjects: | |
Online Access: | http://eprints.usm.my/38537/ https://doi.org/10.1016/S1015-9584(08)60036-6 |
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Summary: | OBJECTIVE: The aim of this study was to determine the cost-effectiveness of using baseline neuromonitoring
(BNM) compared with multimodality monitoring (M3) for severe traumatic brain injury (TBI).
METHODS: Sixty-two patients with severe TBI underwent a prospective observational study where they
were divided into two groups of patients receiving treatment with M3 (32 patients) and BNM (30 patients).
The macro and micro costings were performed on each patient. The Barthel Index score after 1 year was
used as an outcome measurement tool for both groups. The cost-effectiveness (CE) ratio was calculated
using the Poisson regression model.
RESULTS: The costs of equipment and consumables between the groups was statistically significant
(p < 0.001) after correcting for age and severity of injury. Other cost categories were not significantly different.
The crude CE ratios were 168.66 (95% CI: 168.32, 169.03) and 144.16 (95% CI: 143.87, 144.45) for
BNM and M3 respectively. The two crude CE ratios were significantly different (p < 0.001). It was calculated
by controlling or adjusting age, gender, Glasgow Coma Score, Marshall’s classification at admission
and type of injury. The adjusted CE ratios were 171.32 (95% CI: 170.97, 171.68) and 141.50 (95% CI: 141.26,
141.79) for BNM and M3, respectively. The two adjusted CE ratios were significantly different (p < 0.001).
CONCLUSION: The application of M3 for severe TBI was more cost-effective than BNM. All calculations
were made at 3.8 Malaysian Ringgit (MYR) to the United States dollar (USD). [Asian J Surg
2007;30(4):261–6] |
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