Article

OBJECTIVE: To investigate trends of hospital-based health care utilization after
admission to a level I trauma center after acute traumatic brain injury (TBI).
DESIGN: Retrospective review. SETTING: Large urban trauma hospital and a hospital
council data registry consisting of 88 member institutions (>150 hospitals)
covering 15,000 square miles. PARTICIPANTS: All patients (N=5291) admitted to a
level I trauma center between January 1, 2006, and June 30, 2014, who experienced
an acute TBI based on International Classification of Diseases, Ninth Revision
coding. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Included the
incidence and type of select hospital-based services received. Analyses were also
categorized based on demographic and injury-related information. RESULTS: Of the
5291 patients with newly acquired TBI who were admitted, 512 died, leaving 4779
patients for inclusion in the final analysis. Additional health care utilization
from January 1, 2006, and June 30, 2014, was recorded for 3158 patients (66%),
totaling 12,307 encounters, with a median of 3 encounters (interquartile range,
1-5) and a maximum of 102 encounters. Most nonadmission urgent or procedural
visits (96%) and inpatient encounters (93%) occurred in the first year. Of all
the additional encounters, 9769 visits were nonadmission urgent or procedural
visits (79%) with a median charge of $1955. The most common type of encounter was
elective (46%), followed by medical emergency (29%). Of the remaining 2538
inpatient encounters (21%), the mean length of stay was 6 days with a median
charge of $28,450. Medical emergency (39%) and elective admissions (33%) again
were the most common encounter type. CONCLUSIONS: This analysis encompasses
health care utilization across the range of TBI severity and numerous hospital
systems, allowing for a more comprehensive and objective identification of
reasons for readmission. This represents an initial step to developing a
preventive intervention to manage secondary complications postinjury.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS