Changes in patient demographics and outcomes in the inpatient rehabilitation facility traumatic brain injury population from 2002 to 2016: Implications for patient care and clinical trials

Model System:

TBI

Reference Type:

Journal article

Accession No.:

J84126

Journal:

Journal of Neurotrauma

Year, Volume, Issue, Page(s):

2019 , 36, 17, 2513-2520

Publication Website:

Abstract:

Study identified trends in demographics, particularly age, as well as medical characteristics of patients admitted to medical rehabilitation facilities after sustaining a traumatic brain injury (TBI). Data from the Uniform Data System for Medical Rehabilitation were analyzed for 233,843 patients admitted to 1,290 medical rehabilitation facilities after sustaining a TBI from January 1, 2002 through December 31, 2016. Trends for demographic and medical data were evaluated. The results showed mean patient age increased from 54.1 to 64.8 years, rehabilitation length of stay (LOS) decreased from 19 to 14.5 days, and mean admission Functional Independence Measure (FIM) decreased from 56.9 to 54.5. Sex and racial distribution remained relatively stable across all years, as did discharge FIM. There was an increase in Medicare patients from 40.7 to 62.1 percent, a concomitant decrease in commercially insured patients from 29.2 to 15.4 percent, and a decrease in unreimbursed patients from 7.2 to 2.6 percent over the course of the study. The findings indicate that patients admitted to medical rehabilitation facilities after a TBI are significantly older, less functional on admission, staying at rehabilitation facilities for shorter periods of time, but with similar functional status at the time of discharge. Many current TBI patients would fail to meet inclusion criteria for post-acute clinical trials in TBI because of their age, and treatments based on such trials may not be generalizable, which has significant implications on both research and clinical care realms within brain injury rehabilitation.

Author(s):