Article

OBJECTIVE: To examine the unique contribution of self-reported medical
comorbidity and insurance type on disability after traumatic brain injury (TBI).
DESIGN: Inception cohort design at 1-year follow up. SETTING: A university
affiliated rehabilitation hospital. PARTICIPANTS: Adults with mild-complicated to
severe TBI (N=70). INTERVENTION: Not applicable. MAIN OUTCOME MEASURES:
Self-reported medical comorbidities were measured using the Modified Cumulative
Illness Rating Scale, while insurance type was classified as commercial or
government-funded; disability was measured using the Disability Rating Scale.
RESULTS: Two models were run using multiple linear regression, and the
best-fitting model was selected on the basis of Bayesian information criterion.
The full model, which included self-reported medical comorbidity and insurance
type, was significantly better fitting than the reduced model. Participants with
a longer duration of posttraumatic amnesia, more self-reported medical
comorbidities, and government insurance were more likely to have higher levels of
disability. Meanwhile, individual organ systems were not predictive of
disability. CONCLUSIONS: The cumulative effect of self-reported medical
comorbidities and type of insurance coverage predict disability above and beyond
well-known prognostic variables. Early assessment of medical complications and
improving services provided by government-funded insurance may enhance quality of
life and reduce long-term health care costs.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS