The Economic Burden of Pediatric Postconcussive Syndrome

Objective: To estimate the direct costs of pediatric postconcussive syndrome (PCS). Design: Retrospective cohort study. Setting: Subspecialty sports medicine clinics of a large pediatric tertiary care network in the United States. Patients: One hundred fifty-four patients aged 5 to 18 years with PCS, evaluated between 2010 and 2011. Assessment of Independent Variables: Direct costs included visits to sports medicine clinic, visio-vestibular therapy, homebound education, subspecialist referral, and prescription-only medications (amantadine and amitriptyline), all measured beginning at 28 days after injury. Main Outcome Measures: Postconcussive syndrome was defined as persistence beyond 28 days from injury. Results: The cost incurred by each PCS patient for sports medicine visits was $1575, for visio-vestibular therapy was $985, for homebound tutoring was $55, for prescription medications was $22, and for subspecialist referral was $120, totaling $3557 per patient, with a 95% confidence interval range of $2886 to $4257. Conclusions: Given the high economic costs of PCS determined in this study, therapies that mitigate this syndrome may have the potential to be cost-effective and even cost saving.