Perceived health after adult traumatic brain injury: a Group-Based Trajectory Modeling (GBTM) analysis

Abstract

ABSTRACT Objective To provide nationally representative estimates of adults with traumatic brain injury (TBI) and identify clusters of individuals with TBI who follow similar perceived health trajectories using group-based trajectory modeling. Participants Adults (≥18 years old) from panels 9–19 (2004–2015) of the Medical Expenditure Panel Survey (MEPS) who experienced a TBI (n = 949). Design Data from MEPS, a nationally representative database of noninstitutionalized individuals in the USA, were used to 1) produce a national annual estimate of adults with TBI and 2) identify subgroups of patients with TBI who followed different general and mental health trajectories. Main Measures Perceived general health (PGH), perceived mental health (PMH) Results On average, 502 adults per 100,000 noninstitutionalized US adults experienced a TBI annually, and about one million adults are living with a TBI. Three distinct trajectory groups were identified in models of both perceived general health (PGH) and perceived mental health (PMH). TBI type, sex, and persistent disability predicted assignment to a group in the PGH model. TBI type, sex, age, insurance status, family poverty status, and persistent disability predicted assignment to a PMH trajectory. Conclusion Referrals and early-intervention resources should be distributed to individuals with increased risk of following low PGH and/or PMH trajectories.