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创伤性脑损伤患者的健康状况及医疗保健利用结果:一项为期1年的纵向研究。

Health and Health Care Utilization Outcomes for Individuals With Traumatic Brain Injury: A 1-Year Longitudinal Study.

作者信息

Waltzman Dana, Miller Gabrielle F, Xu Likang, Haarbauer-Krupa Juliet, Hammond Flora M

机构信息

Author Affiliations: Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, Georgia (Drs Waltzman, Miller, Xu, and Haarbauer-Krupa); and Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana (Dr Hammond).

出版信息

J Head Trauma Rehabil. 2025;40(4):233-246. doi: 10.1097/HTR.0000000000001008. Epub 2025 Jan 24.

Abstract

OBJECTIVE

Traumatic brain injury (TBI) can result in new onset of comorbidities and limited studies suggest health care utilization following TBI may be high. Setting, Participants, Mean Measures, and Design: This study used 2018 and 2019 MarketScan Commercial Claims and Encounters data to examine differences in longitudinal health outcomes (health care utilization and new diagnoses) by various demographic factors (age, sex, U.S. region, intent/mechanism of injury, urbanicity, and insurance status) among individuals with and without a TBI in the year following an index health care encounter.

RESULTS

Results show that within 1 year of the initial encounter, a higher percentage of patients with TBI versus without TBI had at least one outpatient visit (96.7% vs 86.1%), emergency department (ED) visit (28.5% vs 13.1%), or hospital admission (6.4% vs 2.6%). Both children (33.8% vs 23.4%) and adults (43.8% vs 31.4%) who sustained a TBI had a higher percentage of new diagnoses within 1 year compared to the non-TBI group. Additionally, individuals with a TBI had greater health care utilization across all types of health care settings (outpatient and inpatient), visits (ED visits and hospital admissions), and across all demographic factors ( P < .001).

CONCLUSION

These results may inform future research around the development of systems of care to improve longer-term outcomes in individuals with TBI.

摘要

目的

创伤性脑损伤(TBI)可导致新的合并症出现,且有限的研究表明,TBI后的医疗保健利用率可能较高。背景、参与者、平均测量指标和设计:本研究使用2018年和2019年市场扫描商业索赔和就诊数据,以检查在首次医疗就诊后的一年内,不同人口统计学因素(年龄、性别、美国地区、损伤意图/机制、城市化程度和保险状况)对有和没有TBI的个体纵向健康结局(医疗保健利用率和新诊断)的影响。

结果

结果显示,在初次就诊后的1年内,与无TBI的患者相比,TBI患者中有更高比例的人至少进行了一次门诊就诊(96.7%对86.1%)、急诊就诊(28.5%对13.1%)或住院治疗(6.4%对2.6%)。与非TBI组相比,遭受TBI的儿童(33.8%对23.4%)和成人(43.8%对31.4%)在1年内有新诊断的比例更高。此外,TBI患者在所有类型的医疗保健机构(门诊和住院)、就诊(急诊就诊和住院)以及所有人口统计学因素方面的医疗保健利用率都更高(P < .001)。

结论

这些结果可能为未来围绕开发护理系统以改善TBI患者长期结局的研究提供参考。

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