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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Dave Mellick, MA, Research, Craig Hospital, 3425 S. Clarkson Street, Englewood, CO 80110, 3037898202, dmellick@craighospital.org, Gale Whiteneck, PhD, Director of Research, Craig Hospital, 3425 S. Clarkson Street, Englewood, CO 80110, and Ken Gerhart, MA, Craig Hospital, 3425 S Clarkson, Englewood, CO 80110.
To identify the factors that determine the pathways of care people with traumatic brain injury (TBI ) follow after acute care discharge, and to identify differences in outcome based on those pathways. Included were 1059 individuals who: (a) were discharged from acute care in 1996 and 1997; (b) were eligible for inclusion in the statewide, population-based TBI follow-up system, (c) had either a severe TBI or were among a 20% random sample with milder injuries, and (d) consented to participate in a one-year post-injury follow up survey. The survey included administration of the Functional Independence Measure, the Craig Handicap Assessment and Reporting Technique, the Alertness Behavior Sub-scale of the Sickness Impact Profile, and the Health Status Questionnaire. Medical records for all participants were abstracted for injury severity, pre-injury history, etiologic and demographic, and discharge disposition data. Almost 2/3 of TBI survivors in this population-based sample received no additional services following discharge from the acute care hospital. Of the six post-acute-hospitalization pathways that were identified based on combinations of inpatient rehabilitation, community-based services, and long-term care (LTC), survivors with the severest injuries were over-represented in every care path except the one involving a discharge directly from the acute hospital to home. Older people and people whose care was funded by government payers were over-represented in both care pathways involving LTC, while members of minority groups were under represented. Those who went to LTC had the poorest outcomes, but even those completing rehabilitation had relatively poorer outcomes compared with those discharged directly to home.
Learning Objectives:
Keywords: Traumatic Brain Injury,
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.