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Prevention Science
Published in: Prevention Science 6/2018

01-08-2018

Lifetime Cost of Abusive Head Trauma at Ages 0–4, USA

Authors: Ted R. Miller, Ryan Steinbeigle, Bruce A. Lawrence, Cora Peterson, Curtis Florence, Marilyn Barr, Ronald G. Barr

Published in: Prevention Science | Issue 6/2018

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Abstract

This paper aims to estimate lifetime costs resulting from abusive head trauma (AHT) in the USA and the break-even effectiveness for prevention. A mathematical model incorporated data from Vital Statistics, the Healthcare Cost and Utilization Project Kids’ Inpatient Database, and previous studies. Unit costs were derived from published sources. From society’s perspective, discounted lifetime cost of an AHT averages $5.7 million (95% CI $3.2–9.2 million) for a death. It averages $2.6 million (95% CI $1.0–2.9 million) for a surviving AHT victim including $224,500 for medical care and related direct costs (2010 USD). The estimated 4824 incident AHT cases in 2010 had an estimated lifetime cost of $13.5 billion (95% CI $5.5–16.2 billion) including $257 million for medical care, $552 million for special education, $322 million for child protective services/criminal justice, $2.0 billion for lost work, and $10.3 billion for lost quality of life. Government sources paid an estimated $1.3 billion. Out-of-pocket benefits of existing prevention programming would exceed its costs if it prevents 2% of cases. When a child survives AHT, providers and caregivers can anticipate a lifetime of potentially costly and life-threatening care needs. Better effectiveness estimates are needed for both broad prevention messaging and intensive prevention targeting high-risk caregivers.
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Literature
Adamsbaum, C., Grabar, S., Mejean, N., & Rey-Salmon, C. (2010). Abusive head trauma: Judicial admissions highlight violent and repetitive shaking. Pediatrics, 126, 546–555.CrossRefPubMed
Altman, R. L., Canter, J., Patrick, P. A., Daley, N., Butt, N. K., & Brand, D. A. (2011). Parent education by maternity nurses and prevention of abusive head trauma. Pediatrics, 128, e1164–e1172.CrossRefPubMed
Barr, R. G. (2012). Preventing abusive head trauma resulting from a failure of normal interaction between infants and their caregivers. Proceedings of the National Academy of Sciences, 16, 17294–17301.CrossRef
Barr, R. G., Barr, M., Fujiwara, T., Conway, J., Catherine, N., & Brant, R. (2009). Do educational materials change knowledge and behavior about crying and shaken baby syndrome? Canadian Medical Association Journal, 180, 727–733.CrossRefPubMed
Barr, R. G., Rivara, F. P., Barr, M., Cummins, P., Taylor, J., Lengua, L. J., & Meredith-Benitez, E. (2009). Effectiveness of educational materials designed to change knowledge and behaviors regarding crying and shaken-baby syndrome in mothers of newborns: a randomized, controlled trial. Pediatrics, 123, 972–980.CrossRefPubMed
Blincoe, L. J., Miller, T. R., Zaloshnja, E., & Lawrence, B. A. (2014). The economic and societal impact of motor vehicle crashes, 2010. Washington, DC: National Highway Traffic Safety Administration.
Bloom, B., Cohen, R. A., & Freeman, G. (2011). Summary health statistics for U.S. children: National Health Interview Survey, 2010. National Center for Health Statistics. Vital Health Statistics, 10(250), 1–82.
Bourgeois, F. T., Olson, K. L., Ioannidis, J. P. A., & Mandl, K. D. (2014). Association between pediatric clinical trials and global burden of disease. Pediatrics, 133, 78–87.CrossRefPubMedPubMedCentral
Chambers, J. G., Shkolnik, J., & Perez, M. (2003). Total expenditures for students with disabilities, 1999–2000: Spending variation by disability. Report 5, Special Education Expenditure Project (SEEP). Washington, DC: United States Department of Education, Office of Special Education Programs, American Institutes for Research.
Christian, C. W., Block, R., & Committee on Child Abuse and Neglect. (2009). Abusive head trauma in infants and children. Pediatrics, 123, 1409–1411.CrossRefPubMed
Cobley, C., & Sanders, T. (2007). Non-accidental head injury in young children: Medical, legal, and social responses. Philadelphia, PA: Jessica Kingsley Publishers.
Cohen, M. A., & Miller, T. R. (1998). The cost of mental health care for victims of crime. Journal of Interpersonal Violence, 13, 93–110.CrossRef
Cohen, M., & Miller, T. R. (2003). Willingness to award non-monetary damages and the implied value of life from jury awards. International Review of Law and Economics, 23, 165–181.CrossRef
Cohen, M. A., Rust, R., Steen, S., & Tidd, S. (2004). Willingness-to-pay for crime control programs. Criminology, 42, 86–106.CrossRef
Corso, P. S., Fang, X., & Mercy, J. A. (2011). Benefits of preventing a death associated with child maltreatment: Evidence from willingness-to-pay survey data. American Journal of Public Health, 101, 487–490.CrossRefPubMedPubMedCentral
Coyer, C., & Kenney, G. M. (2013). The composition of children enrolled in Medicaid and CHIP: Variation over time and by race and ethnicity. In Low-income working family paper 22. Washington DC: The Urban Institute.
DeNavas-Walt, C., Proctor, B. D., & Smith, J. C. (2011). Income, poverty, and health insurance coverage in the United States: 2010. U.S. Census Bureau, Current Population Reports, P60–239, U.S. Government Printing Office, Washington, DC.
Dias, M. S., Rottmund, C. M., Cappos, K. M., Reed, M. E., Wang, M., Stetter, C., et al. (2017). Association of a postnatal parent education program for abusive head trauma with subsequent pediatric abusive head trauma hospitalization rates. JAMA Pediatrics online ahead or print. doi:10.​1001/​jamapediatrics.​2016.​4218.
Dias, M. S., Smith, K., DeGuehery, K., Mazur, P., Li, V., & Shaffer, M. L. (2005). Preventing abusive head trauma among infants and young children: a hospital-based, parent education program. Pediatrics, 115, e470–e477.CrossRefPubMed
Drummond, M. F., Schulpher, M. J., Torrance, G. W., O’Brien, B. J., & Stoddart, G. L. (2007). Methods for the economic evaluation of health care programmes (3rd ed.). New York: Oxford University Press.
Fang, X., Brown, D. S., Florence, C. S., & Mercy, J. A. (2012). The economic burden of child maltreatment in the United States and implications for prevention. Child Abuse and Neglect: The International Journal, 36, 156–165.CrossRef
Finkelstein, E. A., Corso, P. C., Miller, T. R., Fiebelkorn, I. A., Zaloshnja, E., & Lawrence, B. A. (2006). Incidence and economic burden of injuries in the United States, 2000. New York: Oxford University Press.CrossRef
Friedman, J., Reed, P., Sharplin, P., & Kelly, P. (2012). Primary prevention of pediatric abusive head trauma: a cost audit and cost-utility analysis. Child Abuse and Neglect, 36, 760–770.CrossRefPubMed
Fujiwara, T., Yamada, F., Okuyama, M., Kamimaki, I., Shikoro, N., & Barr, R. G. (2012). Effectiveness of educational materials designed to change knowledge and behavior about crying and shaken baby syndrome: a replication of a randomized controlled trial in Japan. Child Abuse and Neglect, 36, 613–620.CrossRefPubMed
Husereau, D., Drummond, M., Petrou, S., Carswell, C., Moher, D., Greenberg, D., et al. (2013). Consolidated Health Economic Evaluation Reporting Standards (CHEERS)—explanation and elaboration: a report of the ISPOR health economic evaluation publication guidelines good reporting practices task force. Value in Health, 16, 231–250.CrossRefPubMed
Jenny, C., Hymel, K. P., Ritzen, A., Reinert, S. E., & Hay, T. C. (1999). Analysis of missed cases of abusive head trauma. Journal of the American Medical Association, 281, 621–626.CrossRefPubMed
Keenan, H. T., & Leventhal, J. M. (2010). A case-control study to evaluate Utah’s shaken baby prevention program. Academic Pediatrics, 10, 389–394.CrossRefPubMed
Kochi, I., & Taylor, L. (2011). Risk heterogeneity and the value of reducing fatal risks: Further market-based evidence. Journal of Benefit-Cost Analysis, 2(3), Article 1. doi:10.​2202/​2152-2812.​1079.
Lawrence, B. A., Bhattacharya, S., Zaloshnja, E., Jones, P., Miller, T. R., Corso, P. S., & Steiner, C. A. (2011). Medical and work loss cost estimation methods for the WISQARS cost of injury module (revision 1). Atlanta: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
Lawrence, B. A., Miller, T. R., Jensen, A. F., Fisher, D. A., & Zamula, W. W. (2000). Estimating the costs of non-fatal consumer product injuries in the United States. Injury Control and Safety Promotion, 7, 97–113.CrossRef
Miller, T. R., Bhattacharya, S., Zaloshnja, E., Taylor, D., Bahar, G., & David, I. (2011). Costs of crashes to government, United States, 2008. Annals of Advances in Automotive Medicine, 55, 347–356.PubMed
Miller, T. R., & Hendrie, D. (2014). Incidence and costs of violence and other personal crimes, United States, 2010. Working Paper. Calverton, MD: Pacific Institute for Research and Evaluation.
Miller, T. R., Levy, D. T., Spicer, R. S., & Taylor, D. M. (2006). Societal costs of underage drinking. Journal of Studies on Alcohol, 67, 519–528.CrossRefPubMed
Miller, T. R., Steinbeigle, R., Wicks, A., Lawrence, B. A., Barr, M., & Barr, R. (2014). Disability-adjusted life year burden of abusive head trauma at ages 0–4. Pediatrics, 134, 1545–1550.CrossRef
Mitnik, P. A., & Grusky, D. B. (2015). Economic mobility in the United States. Washington DC: The Pew Charitable Trusts and the Russell Sage Foundation, 2015.
Murray, C. J. L., Abraham, J., & Ali, M. K. (2013). The state of US health, 1990–2010: Burden of diseases, injuries, and risk factors. Journal of the American Medical Association, 310, 591–608.CrossRefPubMed
National Academies of Sciences, Engineering, and Medicine. (2016). Advancing the power of economic evidence to inform investments in children, youth, and families. Washington DC: The National Academies Press.
National Center for Educational Statistics. (2013). Digest of education statistics 2012. Washington DC: US Department of Education.
Neumann, P. J., Sanders, G. D., Russell, L. B., Siegel, J. E., & Ganiats, T. G. (Eds.). (2016). Cost-effectiveness in health and medicine (Second ed.). New York City: Oxford University Press.
Niederkrotenthaler, T., Xu, L., Parks, S. E., & Sugerman, D. E. (2013). Descriptive factors of abusive head trauma in young children—United States, 2000–2009. Child Abuse and Neglect., 37, 446–455.CrossRefPubMed
Obama, B. H., & Advisers, C. O. E. (2014). The economic report of the president. Washington, DC: U.S. Government Printing Office.
Parks, S. E., Sugerman, D., Xu, L., & Coronado, V. (2012). Characteristics of non-fatal abusive head trauma among children in the USA: 2003–2008: Application of the CDC operational case definition to national hospital impatient data. Injury Prevention, 18, 392–398.CrossRefPubMedPubMedCentral
Pointer, I. (2011). Estimating the economic burden of abusive head trauma in children in North Carolina (Master’s paper). Chapel Hill: University of North Carolina.
Ringwalt, C. L., Vincus, A., Hanley, S., Ennett, S., Bowling, J., & Haws, S. (2011). The prevalence of evidence-based drug use prevention curricula in U.S. middle schools in 2008. Prevention Science, 12, 63–69.CrossRefPubMedPubMedCentral
Rivara, F. P., Koepsell, T. D., Wang, J., Temkin, N., Dorsch, A., Vavilala, M. S., et al. (2011). Disability 3, 12, and 24 months after traumatic brain injury among children and adolescents. Pediatrics, 128, e1129–e1138.CrossRefPubMed
Shanahan, M. E., Zolotor, A. J., Parrish, J. W., Barr, R. G., & Runyan, D. K. (2013). National, regional, and state abusive head trauma: Application of the CDC algorithm. Pediatrics, 132, e1546–e1553.CrossRefPubMedPubMedCentral
Strauss, D. J., Shavelle, R. M., & Anderson, T. W. (1998). Long-term survival of children and adolescents after traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 79, 1095–1100.CrossRefPubMed
US Office of Management and Budget (1992) Circular no. A-94 revised. Guidelines and discount rates for benefit-cost analysis of federal programs. Washington DC.
Viscusi, W. K., & Aldy, J. E. (2003). The value of a statistical life: a critical review of market estimates throughout the world. Journal of Risk and Uncertainty, 27(1), 5–76.CrossRef
Xiang, J., Shi, J., Wheeler, K. K., Yeates, K. O., Taylor, H. G., & Smith, G. A. (2013). Paediatric patients with abusive head trauma treated in US emergency departments, 2006–2009. Brain Injury, 27, 1555–1561.CrossRefPubMed
Zolotor, A. J., Runyan, D. K., Shanahan, M., Durrance, C. P., Nocera, M., Sullivan, K., et al. (2015). Effectiveness of a statewide abusive head trauma prevention program in North Carolina. JAMA Pediatrics, 169, 1126–1131.CrossRefPubMedPubMedCentral
Metadata
Title
Lifetime Cost of Abusive Head Trauma at Ages 0–4, USA
Authors
Ted R. Miller
Ryan Steinbeigle
Bruce A. Lawrence
Cora Peterson
Curtis Florence
Marilyn Barr
Ronald G. Barr
Publication date
01-08-2018
Publisher
Springer US
Published in
Prevention Science / Issue 6/2018
Print ISSN: 1389-4986
Electronic ISSN: 1573-6695
DOI
https://doi.org/10.1007/s11121-017-0815-z

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