Estimates suggest that approximately 760,000 people in the UK are living with the long-term effects of a head injury. Individuals suffering from brain injuries have little reduction in life-expectancy, however many cannot return to work and will require full-time care. Thus, there is a significant economic burden associated with acquired brain injury (ABI).
Over the years the Brain Injury Rehabilitation Trust (BIRT) has consistently demonstrated that neurobehavioural rehabilitation is cost-effective. The first study of this kind, was conducted in 1999 by Professor Rodger Wood and colleagues. Since then, two other studies have led to similar results. In 2006, Worthington and colleagues found that rehabilitation led to significant improvements in level of independence, level of care, functional ability and productive occupation.
The researchers carried out economic analyses and determined that the initial costs of rehabilitation were offset by savings in direct care costs within two years. The estimated savings in direct care costs projected across an individual’s lifetime were between £0.9 to £1.1 million, depending on how much time had elapsed between sustaining the injury and admission to rehabilitation.
Seven years later, Oddy and Ramos, repeated the previous analyses in a different cohort. They used changes in levels of supervision before and after rehabilitation as a measure of direct care costs, and again found that significant gains in all areas of functioning were associated with reductions in direct care costs both in individuals who sustained their injury within one year of admission (68% reduction) as well as in those who sustained their injury more than one year before admission (37% reduction).
Savings in societal costs are likely to add to these savings in direct costs, as those who become more independent require less direct supervision, which in turn enables informal carers to return to work, resulting in an overall reduction of costs associated with loss of productivity. Wider benefits resulting from enhanced sense of self-efficacy and individual and caregiver well-being are still to be investigated.
The Brain Injury Rehabilitation Trust, known as BIRT, recently published some research showing significant clinical and cost benefits can be achieved by neurorehabilitation following an acquired brain injury.
The study shows a lifetime cost savings of between £0.57 million and £1.13 million for people admitted to rehabilitation within a year of acquiring their brain injury. Savings of between £0.19 million and £0.86 million were found for individuals admitted to rehabilitation more than a year after injury.
One example shows the annual costs of care before admission to neurorehabilitation were £60,000, yet after neurorehabilitation were just £19,000. The lifetime care cost calculations are made on the assumption that an individual would live an average life expectancy of 36 years after discharge.