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APHA Scientific Session and Event Listing

Recorded presentation

Melissa M. Sendroy-Terrill, MA, Gale G. Whiteneck, PhD, and C. A. Brooks, MSHA. Research Department, Craig Hospital, 3425 S. Clarkson St., Englewood, CO 80113, 303-789-8307, msendroy@craighospital.org

The purpose of this study was to examine service utilization of people with TBI for the first year following discharge from inpatient rehabilitation to determine costs, how payer sources change over time, and association with physical independence. Sixty people who sustained a TBI and admitted to a single comprehensive rehabilitation facility were interviewed to identify service utilization in the first year following discharge. Participants identified more than four-hundred service providers and pharmaceutical and equipment vendors. Providers and vendors were asked for itemized billing statements which included description of services, charges, payer source and reimbursement amounts. Additional information was abstracted from participants' medical records. Change in physical independence from time of discharge to one year follow up was measured by the Functional independence Measure (FIM). In descending order of the percent of total costs, services utilized in the first year included Therapy (Occupational, Physical, Speech), Medical (Physician, radiology, laboratory, dental), Other services, (complementary and alternative therapies), Personal Assistance, Equipment, (pharmaceuticals, home modifications) Psychological services, and Transportation. The payers in descending order included Auto no-fault insurance, Commercial, Medicaid, and Worker's Compensation. The data indicated a shifting of payments from Auto No-Fault and Commercial insurance toward Medicaid. Results demonstrated that higher costs for Therapy services yielded greater and positive changes in physical functional independence. This initial investigation suggests further research in this area is warranted to better understand not only the relationship between services and outcomes but also the financial implications and benefits of resource allocation.

Learning Objectives:

• List services used after traumatic brain injury.
• Understand the relationship between service utlization and functional independence as an outcome.
• Discuss patterns of shifting reimbursement.

Keywords: Traumatic Brain Injury, Cost Issues

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation