Department of Neurorehabilitation, TBI Unit, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Department of Psychology, University of Southern Denmark, Odense, Denmark.
J Neurotrauma. 2020 Dec 15;37(24):2694-2702. doi: 10.1089/neu.2020.7064. Epub 2020 Sep 17.
This study examined if acquiring a traumatic brain injury (TBI) increases utilization of health care costs, increases risk of job loss for the patient and the closest relatives, and increases the risk of divorce 1 to 5 years following the injury. The study was conducted as a Danish national population-based register study with follow-up. Participants included a cohort of patients with TBI ( = 18,328) admitted to a hospital or treated in an emergency room (ER) and a matching control group ( = 89,155). For both the TBI group and the matching controls, relatives were identified, using national registers (TBI relatives: = 25,708 and control relatives: = 135,325). The outcome measures were utilization of health care costs (including hospital services, use of general practitioner and practicing specialists, and prescribed medication), risk of job loss, and risk of divorce among the TBI group and the control group and their relatives. Patients with TBI had significantly increased health care costs at baseline (i.e., the year before the injury) and during the following 4 years. Further, TBI relatives had a significantly higher utilization of health care costs the first and the third year after injury. The TBI group had a significant increased risk of job loss (odds ratio [OR] = 2.88; confidence interval [CI]: 2.70-3.07) and divorce (OR = 1.44; CI: 1.27-1.64) during the first 3 years following injury. In conclusion, the TBI group had significantly higher utilization of health care costs, both pre-morbidly and post-injury. Further, increased risk of job loss and divorce were found, emphasizing that the socioeconomic consequences of TBI last for years post-injury.
这项研究旨在探讨创伤性脑损伤(TBI)是否会增加医疗保健费用的利用,是否会增加患者及其最亲近亲属失业的风险,以及是否会增加受伤后 1 至 5 年内离婚的风险。该研究是一项丹麦全国基于人群的登记研究,进行了随访。参与者包括一组因 TBI 住院或在急诊室(ER)接受治疗的患者(n=18328)和一组匹配的对照组(n=89155)。对于 TBI 组和匹配对照组,均通过国家登记册确定了亲属(TBI 亲属:n=25708;对照组亲属:n=135325)。结局指标包括 TBI 组和对照组及其亲属的医疗保健费用利用(包括医院服务、全科医生和专科医生的使用以及处方药物)、失业风险和离婚风险。TBI 患者在基线(即受伤前一年)和随后的 4 年内医疗保健费用显著增加。此外,TBI 亲属在受伤后的第一年和第三年医疗保健费用的利用率显著更高。TBI 组在受伤后的前 3 年内失业风险(优势比 [OR] = 2.88;置信区间 [CI]:2.70-3.07)和离婚风险(OR=1.44;CI:1.27-1.64)显著增加。总之,TBI 组在受伤前和受伤后都有显著更高的医疗保健费用利用率。此外,还发现失业风险和离婚风险增加,这强调了 TBI 的社会经济后果在受伤后多年仍会持续存在。