Intermediate care for Traumatic Brain Injury Patients and Caregivers in Low-Middle Income Countries: A Narrative Review

Abstract

The continuity of intermediate care in low-middle-income countries (LMIC) is fundamental to support the sustainability of hospital care. Continuity of care is needed for patients with TBI and their caregivers, including intermediate care. However, there is not much literature that discusses intermediate care in patients with TBI and caregivers in LMIC. Therefore, this article is a narrative review to identify inter-mediate care programs for patients with TBI and caregivers in LMIC. This narrative review was conducted the electronic databases: Proquest, PubMed, Science Direct, MedLine, and Google Scholar. The search terms were developed based on MESH terms: 'intermediate care,' 'traumatic brain injury, 'outcome,' 'caregiver, and 'low-middle income countries.' The articles searched with participants were patients with TBI after discharge from the hospital ≥ 18 years old. At the same time, the caregivers were the person who cared for the patients after discharge at home, published in English between January 2011–December 2021. This article search resulted in articles discussing intermediate care for patients with TBI and their caregivers in LMIC on several continents, including Asia, Africa, Latin America, and Europe. In general, there are no intermediate care programs that specifically treat patients with TBI and caregivers at LMIC. When a patient with TBI is discharged from the hospital, a patient rehabilitation program will be provided in the rehabilitation unit in the hospital's outpatient departments. There is variability among LMICs regarding public support for rehabilitative services and disability-related care, in part due to very diverse economic and cultural conditions. The intermediate care program for patients with TBI and caregivers at LMIC is currently undergoing reconstruction and rehabilitation of the health care system. Therefore, a particular program is needed in the intermediate period that focuses on patients with TBI and caregivers to optimize continuity of care and discharge outcomes.