Research Reports - Post-acute TBI rehabilitation: Effects on outcome measures and life care costs

J Neurotrauma. 2014 Dec 13

Griesbach GS(1), Kreber L, Harrington D, Ashley M

Rehabilitation is the predominant post acute treatment for traumatic brain injury
(TBI). Here, we retrospectively evaluated the effectiveness of post-acute TBI
rehabilitation by comparing outcome measures and life care cost with
cerebrovascular accident (CVA) patients that underwent a multidisciplinary
rehabilitation program within the same facility. To better assess the effects of
rehabilitation, we only included patients with no benefit limitations from the
insurance carrier. Functional effectiveness was determined by comparing outcome
scales, which included the Disability Rating Scale, Mayo Portland Inventory,
Occupational Status Scale, Living Status Scale and the Centre for Neuro Skills
Scale. Cost effectiveness was determined by having certified life care planners
create separate cost projections from the admission and discharge patient files.
This allowed us to compare cost projections with and without rehabilitation for
each patient. Significant decreases in the cost projections, i.e.
rehabilitation-savings (RS), were found following rehabilitation for TBI. These
RS were equivalent to those of CVA patients. Likewise, equivalent improvements
were found on all of the outcome scales for both brain injury groups. We also
evaluated if the latency from TBI to admission in the rehabilitation program had
an influence on outcome. Cost and functional effectiveness was more marked when
rehabilitation was initiated within the first year following TBI. The effects of
age of TBI were also evaluated. Although RS were most marked in younger patients,
improvements in outcome measures were observed in all age groups following
past-acute rehabilitation.

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