Bastos Gottgtroy Renata, Hume Patria, Theadom Alice
Sport Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environment Science, Auckland University of Technology, Auckland, New Zealand; Traumatic Brain Injury Network, Faculty of Health and Environment Science, Auckland University of Technology, Auckland, New Zealand.
Traumatic Brain Injury Network, Faculty of Health and Environment Science, Auckland University of Technology, Auckland, New Zealand.
N Z Med J. 2022 Oct 7;135(1563):36-51. doi: 10.26635/6965.5821.
To describe healthcare pathways for mild traumatic brain injury (mTBI) patients in New Zealand and identify areas for improvement.
A data science methodology was applied to mTBI ACC claims (children and adults) between 1 September 2016 and 1 September 2018, and payment and purchase order data until 1 September 2020. Frequency, median and interquartile ranges were used to describe the pathway.
Of the 55,494 claims and 63,642 referrals, >99% were accepted by ACC. Claim processing took more than a week for 7% (3,647) of claims and referral processing took more than three days for 33% (21,139) of referrals. One in four (25%) cases referred to a concussion clinic took >2 months to receive the service due to administrative delays. Of all patients, 36% (20,413) received more than the initial appointment, and their median time in the pathway was 49 days (IQR, 12-185). TBI diagnostic codes were not added at initial appointment in 6% (3,382) of cases.
Administrative claim and referral processes resulted in minimal delays in the pathway for most patients. However, the volume of claims meant delays affected thousands of New Zealanders every year. Pathways could be improved by facilitating mTBI diagnosis, improving follow-up rates and reducing unnecessary administrative processes.
描述新西兰轻度创伤性脑损伤（mTBI）患者的医疗保健途径，并确定改进领域。
将数据科学方法应用于2016年9月1日至2018年9月1日期间的mTBI意外伤害赔偿委员会（ACC）索赔（儿童和成人），以及截至2020年9月1日的支付和采购订单数据。使用频率、中位数和四分位间距来描述该途径。
在55494份索赔和63642份转诊中，超过99%被ACC接受。7%（3647份）的索赔处理时间超过一周，33%（21139份）的转诊处理时间超过三天。因行政延误，四分之一（25%）转诊至脑震荡诊所的病例等待服务的时间超过2个月。在所有患者中，36%（20413例）接受的服务超过了初次预约，他们在该途径中的中位时间为49天（四分位间距，12 - 185天）。6%（3382例）的病例在初次预约时未添加创伤性脑损伤诊断代码。
行政索赔和转诊流程对大多数患者的途径造成的延误最小。然而，索赔数量意味着每年有数千名新西兰人受到延误影响。通过促进mTBI诊断、提高随访率和减少不必要的行政流程，可以改进该途径。
