The Effect of Written and Video Discharge Instructions after Mild Traumatic Brain Injury on Healthcare Costs and Productivity Costs

Amber E. Hoek*, A. J.L.M. Geraerds, Pleunie P.M. Rood, Marieke Joosten, Diederik W.J. Dippel, Ed F. Van Beeck, Leandra Van Den Hengel, Björn Dijkstra, Dafni Papathanasiou, Daphne Van Rijssel, Maaike Van Den Hamer, Stephanie C.E. Schuit, Alex Burdorf, Juanita A. Haagsma, Suzanne Polinder

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objective: To compare healthcare and productivity costs between patients with mild traumatic brain injury (mTBI) who received verbal discharge instructions only and patients who received an additional flyer with or without video instructions. 

Setting: Emergency departments (EDs) of 6 hospitals in the Netherlands. 

Participants: In total, 1155 adult patients with mTBI (384 with verbal instructions; 771 with additional flyer with or without video instructions) were included. 

Design: Cost study with comparison between usual care and intervention. 

Methods: Medical and productivity costs up to 3 months after presentation at the ED were compared between mTBI patients with usual care and mTBI patients who received the intervention. 

Results: Mean medical costs per mTBI patient were slightly higher for the verbal instructions-only cohort (€337 vs €315), whereas mean productivity costs were significantly higher for the flyer/video cohort (€1625 vs €899). Higher productivity costs were associated with higher working age, injury severity, and postconcussion symptoms. 

Conclusion: This study showed that the implementation of flyer (and video) discharge instructions for patients with mTBI who present at the ED increased reports of postconcussion symptoms and reduced medical costs, whereas productivity costs were found to be higher for the working population in the first 3 months after the sustained head injury.

Original languageEnglish
Pages (from-to)E231-E241
JournalJournal of Head Trauma Rehabilitation
Issue number4
Early online date26 Jul 2021
Publication statusPublished - 1 Jul 2022

Bibliographical note

Funding Information:
Hersenstichting (Dutch Brain Foundation) and Spoedeisende Geneeskunde Onderzoeksfonds (Emergency Medicine Research Fund).

Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.


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