Functional status, referral and cost of treatment for persons with traumatic head injury.

This study was conducted to examine functional status, costs of treatment, and how function and costs are related to the referral process of persons with traumatic head injury (THI). The study attempted to answer questions such as: what portion of the THI population is not referred on for subsequent treatment? Is referral dependent upon level of function at time of discharge from acute care? What are the costs associated with different levels of treatment by different facilities? Information was gathered from medical record reviews. Data were gathered from 101 persons with traumatic head injury (PWTHI) using a survey form, a functional assessment inventory, and a performance status scale. Per subject cost statements were obtained from the treatment/service facilities. Results indicate that the factors in the referral process for further treatment and rehabilitation do not appear to be consistent. Acute care referral at discharge is dependent upon severity of residual dysfunction including other factors than THI, while referral at discharge from a rehabilitation centre is dependent upon less obvious factors; one of which may be age at time of injury. Acute care and rehabilitation centre per patient average costs are quite similar and significantly higher than average per client costs.