Planning a system of care for head injuries.

Major improvements in the acute management and rehabilitation of patients with head injury have developed in recent years, particularly in the United States. Australia has lagged behind in these developments, but a co-operative programme between Bethesda Hospital and the Motor Accidents Board in Victoria has improved services for these serious injuries, at least for those resulting from road accidents. It is proposed that integration of services for head injuries would be improved by developing a system of care, based on the proven model for spinal cord injuries, which should not only allow better co-ordination of individual patient care, but also stimulate a more rational development of new services within the health system. The aim is to develop a co-ordinated total care concept for people with head injuries from time of injury, through acute care and rehabilitation to long-term follow-up in the community, a flexible system able to respond to the complexity and variability of these common and serious injuries.