Characterization and correlates of medical and rehabilitation charges for traumatic brain injury during acute rehabilitation hospitalization.

OBJECTIVE

To identify factors associated with specific categories of charges during acute inpatient rehabilitation treatment after traumatic brain injury (TBI).

DESIGN

Prospective observational study.

SETTING

A single Traumatic Brain Injury Model Systems (TBIMS) center.

PARTICIPANTS

Eighty-four consecutive TBIMS patients. One exploratory analysis also included all 350 patients with TBI admitted during 1999.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Average daily charges for specific categories of resource use (eg, room and board, rehabilitation therapies, functional labs).

RESULTS

Room and board and rehabilitation therapy accounted for almost 90% of average daily charges. There was no linear component of change in average daily charges, but certain categories of charges were significantly higher during the first week than thereafter. Functional status at rehabilitation admission correlated with charges for respiratory, medical, and surgical supplies and with pharmacy and radiology, but not the other categories. Specific medical variables also correlated with specific charge categories. Focused chart reviews of patients with low and high charges in specific categories led to the formulation of additional predictive hypotheses.

CONCLUSION

Certain categories of charges correlated with functional scores and acute medical variables that are known before admission to acute inpatient rehabilitation, allowing for better inpatient admission planning under prospective payment. Further research is needed to identify and correlate resource use that is bundled within the room and board category.