Differences in Inpatient Total Costs in Traumatic Brain Injury: A Retrospective Analysis from a Romanian Tertiary Care Center

<b>Introduction:</b> Traumatic brain injury (TBI) represents one of the leading health concerns worldwide, and it is associated with high morbidity, mortality, and substantial healthcare costs. This study aimed to assess inpatient cost determinant factors among TBI patients admitted to an Eastern European hospital, Cluj County Emergency Hospital, Romania, in 2022. <b>Methods:</b> A retrospective observational analysis was conducted on 90 TBI patients. Data on demographic factors, clinical variables, injury characteristics, and inpatient hospital costs were collected. Inpatient total cost differences considering categorical variables were analyzed using Wilcoxon and Kruskal-Wallis tests, and correlations of inpatient total costs with other continuous variables were analyzed using Spearman correlations. <b>Results:</b> Most patients were male (67.8%), urban residents (67.8%), retired (64.4%), and had a mild TBI (96.7%), and the main listed cause was falls (74.4%). The average inpatient cost was EUR 1115.79. There were no statistically significant differences for costs in TBI severity, PTA, or comorbidities. Inpatient costs were correlated with hospital length of stay (ρ = 0.979, 95% CI rho: 0.969 and 986, <i>p</i> < 0.001). While higher costs were seen in patients with PTA, more comorbidities, severe Marshall Scores, or return-to-work status, these differences were not statistically significant. <b>Conclusions:</b> Further research with larger, multicenter cohorts is needed to better understand the cost structure of TBI care and to inform policy decisions that are aimed at resource allocation and cost efficiency.