Research Reports - Description of the moderate brain injured patient and predictors of discharge to rehabilitation

Arch Phys Med Rehabil. 2014 Oct 8

Rogers S(1), Richards KC(2), Davidson M(2), Weinstein AA(2), Trickey AW(3)

OBJECTIVE: To describe moderate traumatic brain injured (TBI) patients between
the ages of 18 to 64 years, treated and discharged alive at level I and level II
trauma centers in the United States, and the predictors of discharge to
rehabilitation after acute care.
DESIGN: Retrospective, cross-sectional, descriptive study.
SETTING: Level I and level II trauma centers within the United States.
PARTICIPANTS: Moderate TBI patients between the ages of 18 to 64 years (N=2,087)
as reported in the 2010 National Sample Project (NSP).
INTERVENTIONS: None MAIN OUTCOME MEASURE: Discharge Destination (Rehabilitation
vs. Home with no Services).
RESULTS: Multivariate logistic regression models revealed that demographic,
clinical, and financial characteristics influenced the likelihood of being
discharged to rehabilitation. Increased age, increased severity, Medicare, longer
length of stay (LOS), and trauma center locations in the Midwest and Northeast
all increased likelihood of discharge to rehabilitation.
CONCLUSIONS: The decision to discharge a person with a moderate TBI from acute
care to rehabilitation appears to be based on factors other than just clinical
need. These findings should be considered in creating more equitable access to
post-acute rehabilitation services for moderate TBI patients because they risk
long-term physical and cognitive problems and have the potential for productive
lives with treatment.

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