The Woes of Economic Burden of Traumatic Brain Injury (TBI) Cases Borne by Public Sector Hospital of Pakistan

  • SYED SHAHZAD HUSSAIN Department of Neurosurgery, Jinnah Hospital
  • USMAN AHMAD KAMBOH Department of Neurosurgery, Jinnah Hospital
  • MUHAMMAD ASIF RAZA Department of Neurosurgery, Jinnah Hospital
  • MADIHA KANWAL Department of Neurosurgery, Jinnah Hospital
  • SAMAN SHAHID National University of Computer & Emerging Sciences (NUCES), Lahore
  • NAVEED ASHRAF Department of Neurosurgery, Jinnah Hospital
Keywords: Traumatic Brain Injury, ICU setup cost, Salaries of medical staff, TBI Financial burden


Objectives: To highlight the role of public sector hospitals in sharing the major burden of severely head injured patients in a resource constrained economically striving country
Materials and Methods: The study was conducted in the Neurosurgery department of Jinnah Hospital, Lahore, Pakistan. 70 patients with moderate to severe TBI cases above one year of age were included. The data was analyzed for the cost estimation for the period of six months, for the following heads: 1) hospital cost per day, 2) ICU setup cost per day, and 3) salaries of hospital staff per day.
Results: There were 53 cases of moderate injury and 17 cases of severe injury. Mean hospital stay was 14 days, minimum number of stay was 2 days and the maximum number of stay was 124 days in six months. Overall, in six months, per day cost of hospital bills head was Rs. 42,333/$ 263/€ 238. For the ICU setup head, the total cost was Rs. 17,9923/$1130/€ 1016 per day. The salary head’s total cost was Rs. 2573/$16.06/€ 14.44. The grand total of all heads, (bills, ICU setup & salaries) was Rs. 22,482,29/$1409/€ 1270.
Conclusion: We evaluated the cost effectiveness of the Neurocritical care unit of a public sector hospital who provides the best possible health care facilities at a cheaper rate as compared to developed countries. We are highlighting the economic burden borne by the developing country’s government.


1. Scholten AC, Haagsma JA, Panneman MJ, Van Beeck EF, Polinder S. Traumatic brain injury in the Netherlands: incidence, costs and disability-adjusted life years. PLoS one, 2014; 9 (10): e110905.
2. Berg J, Tagliaferri F, Servadei F. Cost of trauma in Europe. European Journal of Neurology, 2005; 12: 85-90.
3. Meerding WJ, Mulder S, Van Beeck EF. Incidence and costs of injuries in The Netherlands. The European Journal of Public Health, 2006; 16 (3): 271-7.
4. Polinder S, Meerding WJ, van Baar ME, Toet H, Mulder S, van Beeck EF. Cost estimation of injury-related hospital admissions in 10 European countries. Journal of Trauma and Acute Care Surgery, 2005; 59 (6): 1283-91.
5. Schootman M, Buchman TG, Lewis LM. National estimates of hospitalization charges for the acute care of traumatic brain injuries. Brain injury, 2003; 17 (11): 983-90.
6. Runge JW. The cost of injury. Emergency medicine clinics of North America, 1993; 11 (1): 241-53.
7. Olesen J, Gustavsson A, Svensson M, Wittchen HU, Jönsson B, Group CS, et al. The economic cost of brain disorders in Europe. European journal of neurology, 2012; 19 (1): 155-62.
8. Ma VY, Chan L, Carruthers KJ. Incidence, prevalence, costs, and impact on disability of common conditions requiring rehabilitation in the United States: stroke, spinal cord injury, traumatic brain injury, multiple sclerosis, osteoarthritis, rheumatoid arthritis, limb loss, and back pain. Archives of physical medicine and rehabilitation, 2014; 95 (5): 986-95. e1.
9. Humphreys I, Wood RL, Phillips CJ, Macey S. The costs of traumatic brain injury: a literature review. Clinico-Economics and outcomes research: CEOR. 2013; 5: 281.
10. Faul M, Wald MM, Rutland-Brown W, Sullivent EE, Sattin RW. Using a cost-benefit analysis to estimate outcomes of a clinical treatment guideline: testing the Brain Trauma Foundation guidelines for the treatment of severe traumatic brain injury. Journal of Trauma and Acute Care Surgery, 2007; 63 (6): 1271-8.
11. Langlois JA, Rutland-Brown W, Thomas KE. Traumatic brain injury in the United States; emergency department visits, hospitalizations, and deaths, 2006.
12. McGregor K, Pentland B. Head injury rehabilitation in the UK: an economic perspective. Social science & medicine, 1997; 45 (2): 295-303.
13. Schulman J, Sacks J, Provenzano G. State level estimates of the incidence and economic burden of head injuries stemming from non-universal use of bicycle helmets. Injury prevention, 2002; 8 (1): 47-52.
14. Kayani NA, Homan S, Yun S, Zhu BP. Health and economic burden of traumatic brain injury: Missouri, 2001–2005. Public health reports, 2009; 124 (4): 551-60.
15. Siddiqui UT, Tahir MZ, Shamim MS, Enam SA. Clinical outcome and cost effectiveness of early tracheostomy in isolated severe head injury patients. Surgical neurology international, 2015: 6.
16. Farhad K, Khan HM, Ji AB, Yacoub HA, Qureshi AI, Souayah N. Trends in outcomes and hospitalization costs for traumatic brain injury in adult patients in the United States. Journal of neurotrauma, 2013; 30 (2): 84-90.
Original Article