Brain injuries: health care capacity and policy in Georgia.

Eka Burkadze,Nino Chkhaberidze,Nino Chikhladze,George Lobzhanidze,Corinne Peek‐Asa

doi:10.5249/jivr.v13i1.1541

Eka Burkadze, Nino Chkhaberidze + Show 3 more

Open Access

https://doi.org/10.5249/jivr.v13i1.1541

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Abstract

:Background:Over 90% of morbidity and mortality associated with traumatic brain injury (TBI) occurs in low- and middle-income countries. Lack of reliable, high-quality data regarding TBI prevention and care hinders the ability to reduce TBI burden. We sought to identify current TBI data collection practices and capacity in Georgia, focusing on pre-hospital, hospital, and rehabilitation treatment.Methods:The eight level I and two level II Trauma Hospitals in Georgia with the highest number of TBI admissions in 2017 were selected for study. A semi-structured survey about various aspects of TBI care was designed and semi-structured interviews of healthcare providers treating TBI patients (e.g. neurologists, neurosurgeons) were conducted based on this survey. Results:Pre-hospital triage protocols were not routinely used to match patient treatment needs with hospital capacity. All hospitals provided specialist care for TBI 24 hours/day. MRI was available at only three (30%) centers, and in-hospital rehabilitation units were available in only one (10%). No center used a defined protocol for treating TBI patients and no national protocol exists.Conclusions:Even among the largest, most highly specialized hospitals in Georgia, TBI care varies in terms of diagnostic and treatment protocols. While TBI specialists are available, diagnostic equipment often is not. Gaps in pre-hospital coordination and access to rehabilitation services exist and provide areas of focus for future investment in reducing TBI burden.

Highlights

Traumatic brain injury (TBI) is an important public health issue for countries with emerging economies such as Georgia because health burden can negatively impact economic growth
According to 2017 data obtained from the National Center for Disease Control and Public Health, 6918 traumatic brain injury (TBI)-related hospitalizations occurred in Georgia; 3441 (49.7%) of these patients were admitted in the capital city of Tbilisi
The data reported here were collected as a part of the project INITIaTE: International Collaboration to Increase Traumatic Brain Injury Surveillance in Europe, funded by the United States National Institutes of Health and led by the University of Iowa and the Cluj School of Public Health (NIH/NINDS R21NS098850)

Summary

Introduction

Traumatic brain injury (TBI) is an important public health issue for countries with emerging economies such as Georgia because health burden can negatively impact economic growth. Georgia has a growing transportation infrastructure and a rising rate of road traffic crashes, which are one of the leading causes of TBI.[1] According to 2017 data obtained from the National Center for Disease Control and Public Health, 6918 TBI-related hospitalizations occurred in Georgia; 3441 (49.7%) of these patients were admitted in the capital city of Tbilisi. We sought to identify current TBI data collection practices and capacity in Georgia, focusing on pre-hospital, hospital, and rehabilitation treatment. Conclusion: Even among the largest, most highly specialized hospitals in Georgia, TBI care varies in terms of diagnostic and treatment protocols. Gaps in pre-hospital coordination and access to rehabilitation services exist and provide areas of focus for future investment in reducing TBI burden

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