Cost Benefits of CT after Mild Head Injury

Article:

Immediate computed tomography or admission for observation after mild head injury: cost comparison in randomized controlled trial

Authors:

Anders Norlund, Lars-Åke Marké, Jean-Luc af Geijerstam, Sven Oredsson, Mona Britton

Journal:

BMJ, August 8, 2006

Summary:

The purpose of this study was to compare the costs of immediate computed tomography during triage for admission with those of observation in hospital in patients with mild head injury. Prospective cost effectiveness analyses were performed within a multicenter, randomized trial, utilizing data from 39 acute hospitals, and 2602 patients. Primary outcome measures included direct and indirect costs related to the mild head injury during the acute and three month follow-up period.

Norlund et al found that the outcome after three months was similar for both strategies (non-significantly in favor of computed tomography). For the acute stage and complications, the cost
was $582 per patient in the computed tomography group and $854 in the observation group, meaning an average of 32% less in the computed tomography group.

Sensitivity analysis showed that computed tomography was the most cost effective strategy under a broad range of assumptions. Norlund et al concluded that “patients with mild head injury attending an emergency department can be managed more cost effectively with computed tomography rather than admission for observation in hospital.”

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