{"id":"5b81406e-4a55-42ef-aa90-369d8435fdd3","slug":"economic-burden-and-cost-drivers-of-traumatic-brain-injury","title":"Economic burden and cost drivers of traumatic brain injury","authors":["Agbéko Komlan Doleagbenou","Prisca Assogba","Kisito Quenum","Ben Djoubairou","Kpelao Essossinam"],"abstract":"Background: Traumatic brain injury (TBI) is a significant public health concern in low-income countries. This study assesses the economic burden of TBI in Togo, estimating both direct and indirect costs and identifying key cost drivers. Methods: We conducted a cross-sectional study at CHU Sylvanus Olympio in Lomé from January to December 2022, including patients with complete medical and financial records. Direct medical costs included expenditures directly related to hospital-based medical care from admission to discharge, consultation fees, laboratory investigations, radiological examinations, medications, surgical procedures, intensive care charges, and hospitalization fees. Indirect costs included nonmedical and productivity-related expenses incurred during hospitalization: transportation, food, communication expenses, and loss of income for both patients and caregivers due to missed workdays. Results: A total of 219 patients were analyzed (mean age 37.3 ± 14.1 years; 81.7% male). Road traffic accidents accounted for 86.7% of TBIs, with motorcycles involved in the vast majority. The median total cost of care was USD 512 (IQR: 380–890), and the mean cost was USD 648 ± 478 — approximately 7.1 times the national monthly minimum wage. Direct medical costs constituted the largest share of expenditures, particularly treatment-related items. Intensive care unit admission, surgical intervention, and longer hospital stay were all significantly associated with higher total costs (p< 0.005). Conclusion: TBI management imposes a substantial financial burden in this tertiary hospital setting in Togo. Resource-intensive care, particularly surgery, intensive care admission, and longer hospital stay, significantly increases costs. Broader studies are needed to assess the full national and long-term economic burden of TBI. The financial burden of TBI management in our setting is considerable, particularly given limited health insurance coverage. TBI management imposes a substantial economic burden in this tertiary hospital setting, with costs significantly driven by intensive care admission, surgical intervention, and prolonged hospitalization.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/sni-17-390/figures/SNI-17-390-t001.jpg","publishDate":"2026-07-10T00:00:00.000Z","doi":"10.25259/SNI_573_2025","categories":["Trauma","Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/articles/sni-17-390/SNI-17-390.pdf"}