The mean age of the 112 patients was 32.3 years (SD 12.1 years) and over 80% were employed. (Table 1). Almost half of the patients were in the age group of 26-45 years old, followed by 38.4% in the 18-25 years old category. The majority of the patients were male (90.2%), while the rest were female pillion sitters. 20.5% (n=23) were using a helmet at the time of crash while, 79.5% (n=89) were not wearing a helmet. 
Hemet users were more likely to be discharged from the emergency department, whereas motorcyclists who were not wearing helmet were significantly more likely to be hospitalized at the neurology trauma ICU (58% vs 19.6%, p=0.020). However, there was an insignificant difference in the consumption of emergency healthcare services between the helmeted and non-helmeted groups. Moreover, helmet non-users were more likely to be diagnosed with a TBI (traumatic brain injury) on a CT-scan as compared to the helmet users (p=0.020). Furthermore, helmet users had a significantly shorter length of stay in the ICU (in days) as compared to non-users (mean 1.5 SD 0.71 vs mean 4.29 SD 3.58, p=0.013). However, there is an insignificant difference in the need for mechanical ventilation and neurological surgery between the two groups (p=0.559, 0.465 respectively) (Table 2). 
The total median healthcare cost and sub-components are reported in Table 3 from the perspective of patients and the healthcare facility (unit cost). Out-of-pocket (OOPs) is the cost burden on the patients, while healthcare costs are the estimated costs paid by the public healthcare facility while managing these patients for head injuries. Helmet users had significantly lower total healthcare costs during hospitalization as compared to non-users, with a median PKR.10796 ($69) [IQR 9851 ($63) to 12,581 ($80)] versus a median PKR.12113 ($77) [IQR 10,431 ($66) to 50,545 ($322)] (p< 0.05). From the patient's perspective, the OOPs costs for healthcare services, medicine charges, and travel cost during hospitalization was significantly lower among helmet users compared to non-users, with a median PKR.17750 ($113) [IQR 16,650 ($106) to 18,000 ($115)] versus a median PKR.19800 ($126) [IQR 12,300 ($78) to 30,900 ($197)] (p< 0.05). 
Furthermore, cost on the healthcare facility was also significantly less in the helmeted group. Helmet users consumed significantly less healthcare cost on diagnostic services of laboratory and radiology investigations as compared to non-users, with a median PKR.365 ($2) [IQR 365 ($2) to 548 ($3)] versus a median PKR.3650 ($23) [IQR 365 ($2) to 5840 ($37)] (p= 0.027) for laboratory investigations and a median PKR.4096 ($26) [IQR 3166 ($20) to 5678 ($36)] versus a median PKR.4750 ($30) [IQR 3166 ($20) to 11,358 ($72)] for radiology investigations. Moreover, helmet users had a significantly lower ICU bed cost, with a median PKR.11065 ($70) [IQR 11,065 ($70) to 11,065 ($70)] compared to the non-users with a median PKR.33196 ($211) [IQR 22,131 ($141) to 49,795 ($317)] (p= 0.017).