Charges associated with preventable trauma transfers after application of pediatric brain injury guidelines (kBIG).

INTRODUCTION

Preventable pediatric trauma transfers impose substantial economic burdens on healthcare systems by overutilization of specialized facilities and resources. The brain injury guidelines for kids (kBIG) safely standardize care and reduce unnecessary transfer and interventions for children with traumatic brain injuries (TBI). This study examines how kBIG impacts hospital and transfer charges for low-risk pediatric TBI patients transferred to a level 1 trauma center.

METHODS

A retrospective cohort of pediatric blunt trauma patients with TBI at a level 1 pediatric trauma center from 2018 to 2024 was identified. After chart review and kBIG application, hospital and transfer charges for patients with low-risk, isolated head injuries (kBIG 0 and 1, AIS other body area ≤1) were analyzed.

RESULTS

Of 1894 patients, 204 kBIG 0 (11 %) and 203 kBIG 1 (11 %) were transferred. Total hospital charges were estimated $6.6 M over the 6-year study period. Among these patients, 12 % of kBIG 0 and 18 % of kBIG 1 underwent repeat head CT, while 44 % of kBIG 0 and 67 % of kBIG 1 received neurosurgical consultation. There were 11 % of kBIG 0 and 12 % of kBIG 1 who were transferred by aircraft (transfer charges ∼$2.2 M) with the remaining patients transported by ground (transfer charges ∼$1.7 M). In total, the 6-year hospital and transfer charges were approximately $10.7 M, corresponding to $1.8 M annually.

CONCLUSION

The financial burden and overutilization of resources associated with pediatric low-risk TBI are significant. Implementing the kBIG to reduce these burdens on the families while maintaining patient safety.

LEVEL OF EVIDENCE: III.