The abstract below is from the November 2012 edition of the Journal of Child Abuse and Neglect.
The full article is behind a paywall, but the abstract indicates this study from the folks at Starship Children’s in NZ will be a solid step forward in making the economic case for prevention. Click on this link for the abstract.
More good work from the Starship!
PS. This seems to provide a good template for replicating the analysis on our side of the Equator, no?
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Primary prevention of pediatric abusive head trauma: A cost audit and cost-utility analysis.J Friedman, P Reed, P Sharplin, and P KellyChild Abuse Negl, November 8, 2012
Te Puaruruhau (Child Protection Team), Starship Children's Hospital, Private Bag 92024,Auckland 1142, New Zealand. OBJECTIVES: To obtain comprehensive, reliable data on the direct cost of pediatric abusive head trauma in New Zealand, and to use this data to evaluate the possible cost-benefit of a national primary prevention program.
METHODS: A 5 year cohort of infants with abusive head trauma admitted to hospital inAuckland, New Zealand was reviewed. We determined the direct costs of hospital care (from hospital and Ministry of Health financial records), community rehabilitation (from the Accident Compensation Corporation), special education (from the Ministry of Education), investigation and child protection (from the Police and Child Protective Services), criminal trials (from the Police, prosecution and defence), punishment of offenders (from the Department of Corrections) and life-time care for moderate or severe disability (from the Accident Compensation Corporation). Analysis of the possible cost-utility of a national primary prevention program was undertaken, using the costs established in our cohort, recent New Zealand national data on the incidence of pediatric abusive head trauma, international data on quality of life after head trauma, and published international literature on prevention programs.
RESULTS: There were 52 cases of abusive head trauma in the sample.
Hospital costs totaled: $NZ 2,433,340,child protection: $NZ 1,560,123,police investigation: $NZ 1,842,237,criminal trials: $NZ 3,214,020,punishment of offenders: $NZ 4,411,852 andcommunity rehabilitation: $NZ 2,895,848. Projected education costs for disabled survivors: $NZ 2,452,148, and the cost of projected lifetime care:$NZ 33,624,297. Total costs were $NZ 52,433,864, averaging $NZ 1,008,344 per child.[NB. current exchange rate 1.00 NZ = .81 US] Cost-utility analysis resulted in a strongly positive economic argument for primary prevention, with expected case scenarios showing lowered net costs with improved health outcomes. CONCLUSIONS: Pediatric abusive head trauma is very expensive, and on a conservative estimate the costs of acute hospitalization represent no more than 4% of lifetime direct costs.If shaken baby prevention programs are effective, there is likely to be a strong economic argument for their implementation. This study also provides robust data for future cost-benefit analysis in the field of abusive head trauma prevention.
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