000			03767nab a22003377a 4500
999			_c6976 _d6976
005			20250625151542.0
008			210120s2012 -nz||||| |||| 00| 0 eng d
040			_aAFVC
100			_aFriedman, Joshua _99650
245			_aPrimary prevention of pediatric abusive head trauma : _cJoshua Friedman, Peter Reed, Peter Sharplin and Patrick Kelly _ba cost audit and cost-utility analysis
260			_c2012 _aElsevier,
500			_aChild Abuse & Neglect, 2012, 36(11-12): 760-770
520			_aObjectives: 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 in Auckland, 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 $NZ2,433,340, child protection $NZ1,560,123, police investigation $NZ1,842,237, criminal trials $NZ3,214,020, punishment of offenders $NZ4,411,852 and community rehabilitation $NZ2,895,848. Projected education costs for disabled survivors were $NZ2,452,148, and the cost of projected lifetime care was $NZ33,624,297. Total costs were $NZ52,433,864, averaging $NZ1,008,344 per child. 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. (Authors' abstract). The article and a subsequent letter (2019) are reprinted in Patrick Kelly's doctoral thesis (Chapter 7).published in 2020 - follow the link. Record #6976
650		0	_97583 _aABUSIVE HEAD TRAUMA
650		0	_aCHILD ABUSE _9103
650		0	_aCHILD PROTECTION _9118
650		0	_aDATA ANALYSIS _9181
650		4	_aECONOMIC COSTS _95369
650		4	_aHEALTH SERVICES _9290
650		4	_aPRIMARY PREVENTION _93268
650		0	_aTRAUMATIC BRAIN INJURY _93258
651		4	_aNEW ZEALAND _92588
700			_aReed, Peter _92994
700			_aSharplin, Peter _99651
700			_aKelly, Patrick _91477
773	0		_tChild Abuse & Neglect, 2012, 36(11-12): 760-770
830			_aChild Abuse & Neglect _94477
856			_uhttps://doi.org/10.1016/j.chiabu.2012.07.008 _zDOI: 10.1016/j.chiabu.2012.07.008
856			_uhttps://library.nzfvc.org.nz/cgi-bin/koha/opac-detail.pl?biblionumber=6974 _zReprinted in thesis (Ch. 7)
942			_2ddc _cARTICLE