Abstract
Acquired brain injury (ABI) is a major global public health problem and source of disability. A major contributor to disability after severe ABI is limited access to multidisciplinary rehabilitation, despite evidence of sustained functional gains, improved quality of life, increased return-to-work, and reduced need for long-term care. A societal model of value in rehabilitation matches patient and family expectations of outcomes and system expectations of value for money. A policy analysis of seven studies (2009–2019) exploring outcomes and cost-savings from access to multi-disciplinary rehabilitation identified average lifetime savings of $1.50M per person, with costs recouped within 18 months.Recommendations: Increase access to multi-disciplinary rehabilitation following severe ABI; strengthen prevention focus; increase access to case management; support return-to-work; and systematically collect outcome and cost data.
Highlights
Acquired brain injury (ABI) from traumatic brain injury (TBI), stroke, infectious disease, metabolic disorders, and brain tumors is a major global public health problem [1]
An severe ABI (sABI) impacts the life of an individual and their family, and has a large community, societal and economic toll [3]
A man hospitalized for a TBI at age 40 could be expected to need assistance with one or more activities of daily living for 23–32 more years [10]
Summary
Acquired brain injury (ABI) from traumatic brain injury (TBI), stroke, infectious disease, metabolic disorders, and brain tumors is a major global public health problem [1]. A severe ABI (sABI) is any injury to the brain that occurs after birth, disrupts brain function, and has serious consequences (functional, cognitive, psycho-social) for the injured individual. Severe traumatic brain injury is defined as resulting in loss of consciousness for 6–24 hours or more [2]. In the chronic phase of ABI from any cause, lifelong disabilities may affect the ability to work, perform activities of daily living (dressing, paying bills), participate in community life, and/or fulfill a family role. An sABI impacts the life of an individual and their family, and has a large community, societal and economic toll [3]. Lifetime costs have increased significantly because advances in emergency medical care and neurosurgery enable more people to survive a hospitalization for brain injury [6, 7]. A man hospitalized for a TBI at age 40 could be expected to need assistance with one or more activities of daily living for 23–32 more years [10]
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