Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, USA.
Department of Psychology, Indiana University-Purdue University - Indianapolis, Indianapolis, USA.
Brain Inj. 2021 Jan 5;35(1):119-129. doi: 10.1080/02699052.2020.1861650. Epub 2020 Dec 24.
: The purpose of this study was to characterize health services utilization among individuals hospitalized with a traumatic brain injury (TBI) 1-year post-injury.: Using a retrospective cohort design, adult patients (n = 32, 042) hospitalized with a traumatic brain injury between 2005 and 2014 were selected from a statewide traumatic brain injury registry. Data on health services utilization for 1-year post-injury were extracted from electronic medical and administrative records. Descriptive statistics and logistic regression were used to characterize the cohort and a subgroup of superutilizers of health services.: One year after traumatic brain injury, 56% of participants used emergency department services, 80% received inpatient services, and 93% utilized outpatient health services. Superutilizers had ≥3 emergency department visits, ≥3 inpatient admissions, or ≥26 outpatient visits 1-year post-injury. Twenty-six percent of participants were superutilizers of emergency department services, 30% of inpatient services, and 26% of outpatient services. Superutilizers contributed to 81% of emergency department visits, 70% of inpatient visits, and 60% of outpatient visits. Factors associated with being a superutilizer included sex, race, residence, and insurance type.: Several patient characteristics and demographic factors influenced patients' healthcare utilization post-TBI. Findings provide opportunities for developing targeted interventions to improve patients' health and traumatic brain injury-related healthcare delivery.
本研究旨在描述创伤性脑损伤(TBI)患者出院后 1 年的健康服务利用情况。采用回顾性队列设计,从全州创伤性脑损伤登记处中选取了 2005 年至 2014 年期间因创伤性脑损伤住院的成年患者(n=32042)。从电子病历和管理记录中提取了 1 年创伤后健康服务利用的数据。使用描述性统计和逻辑回归来描述队列和健康服务超利用者亚组。在创伤性脑损伤后 1 年,56%的参与者使用了急诊服务,80%接受了住院服务,93%利用了门诊健康服务。超利用者在 1 年内至少有 3 次急诊就诊、至少有 3 次住院或至少有 26 次门诊就诊。26%的参与者是急诊服务的超利用者,30%是住院服务的超利用者,26%是门诊服务的超利用者。超利用者贡献了 81%的急诊就诊、70%的住院就诊和 60%的门诊就诊。成为超利用者的相关因素包括性别、种族、居住地和保险类型。几个患者特征和人口统计学因素影响了创伤性脑损伤后患者的医疗保健利用情况。研究结果为开发有针对性的干预措施提供了机会,以改善患者的健康状况和创伤性脑损伤相关医疗服务的提供。