Model System:


Reference Type:

Journal article

Accession No.:



Journal of Head Trauma Rehabilitation

Year, Volume, Issue, Page(s):

, 37, 2, 89-95

Publication Website:


Study identified patient, hospital, and geographic characteristics of older adult Medicare beneficiaries hospitalized with traumatic brain injury (TBI) and admitted to long-term acute care hospitals (LTACHs). Data were analyzed for a total of 15,148 Medicare beneficiaries, aged 65 years and older with an acute TBI hospitalization, who were discharged to an LTACH. Patient variables (age, sex, premorbid health burden, medical complications and procedures), hospital variables (for-profit status, bed size), and state/regional geographic variation associated with LTACH TBI admission were evaluated. Older adult Medicare beneficiaries admitted to LTACH facilities following TBI hospitalization were on average 77.1 years old and predominantly White males. In total, 94.6 percent of the sample had 2 or more conditions present during acute hospitalization. Average acute hospital length of stay was 19.4 days, and rates of acute mechanical ventilation of any duration and tracheostomy procedures were 56.6 percent and 40 percent, respectively. Only 4.1 percent of patients seen in LTACHs were discharged; the primary discharge disposition was skilled nursing facilities (41.3 percent). Geographic analyses indicated that selected Southern and Midwestern states had the greatest number of LTACH facilities and proportion of LTACH admissions. Findings among older adult Medicare beneficiaries suggest that this population is highly medically complex and are seldom discharged home after their LTACH stay. There are also notable geographic variations in LTACH TBI admissions across the United States. More research is warranted to understand long-term functional outcomes among this population.


Kumar, Raj G.|Zhang, Wenhan|Evans, Emily|Dams-O'Connor, Kristen|Thomas, Kali S.|

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