Discharge Destination from Acute Care after Traumatic Brain Injury

Abstract

To identify the impact of private insurance coverage on discharge disposition after a traumatic brain injury (TBI) using injury in a motor vehicle accident (MVA) as a proxy for private insurance, controlling for age and severity of injury. Cross-sectional study. Patients with TBI discharged between 1993-1994 and 2000-2001 (n = 9,703). Discharge destination from acute care; controlled odds ratio (OR) and confidence interval (CI) for type of injury. Type of injury, age, and length of stay are significantly associated with discharge destination. However, the motor vehicle accident patients are 56% more likely to be discharged to home with support services than patients with similar injuries from falls. Even in a system with universal coverage, availability of private insurance type is a potential independent determinant of post-acute care services. More research is required to determine the effect this relationship has on the cost and outcomes of care for TBI patients.