Hospital costs of non-traumatic intracranial hemorrhage in older adults in a developing country: a retrospective cohort study

Abstract

Background
Non-traumatic intracranial hemorrhage represents a major contributor to morbidity and healthcare costs among older adults in developing countries. This study examined admission level hospital costs and identified key cost determinants among patients aged 65 years and older treated at a national neurosurgical center in Oman.


Methods
Medical data with their costs were retrospectively collected for 275 patients diagnosed with non-traumatic intracranial hemorrhage aged ≥ 65 years who were admitted under the Neurosurgical department’s care between 2016 and 2019.


Results
The most common diagnoses were subdural hematoma (SDH) (56.36%) followed by intracerebral hemorrhage (ICH) (14.18%) and subarachnoid hemorrhage (SAH) (9.09%). Total 275 admissions, with an elective to emergency surgeries ratio of 1:1.73. with an average cost per patient of $3265. The mean age of patients was 75 years. There was a significant relationship between the surgery type (emergency vs. elective) and the average cost (p value < 0.005). Also, there was a significant difference between the average cost and LOS (p value < 0.005). The total cost of radiological investigations throughout the 4 years was $141884.6. While laboratory investigations costs totaled $101681.58.


Conclusion
Emergency surgical intervention and prolonged hospitalization were identified as the principal cost drivers among older adults with non-traumatic intracranial hemorrhage. These findings can improve hospital budgeting and cost reduction, including strategies to shorten length of stay, prevent complications, and limit the use of unnecessary imaging and laboratory.