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Abstract
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OBJECTIVE: To investigate trends of hospital-based health care utilization after admission to a Level 1 trauma center following acute traumatic brain injury (TBI).
DESIGN: Retrospective review. SETTING: Large urban trauma hospital and a hospital council data registry consisting of 88 member institutions (>150 hospitals) covering 15,000 square miles. PARTICIPANTS: All patients admitted to a Level I trauma center between January 2006 - June 2014 who experienced an acute TBI based on ICD-9 coding. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Included the incidence and type of select hospital-based services received. Analyses were also categorized based on demographic and injury-related information.
RESULTS: There were 5,291 patients with newly acquired TBI admitted; 512 died, leaving 4,779 patients for inclusion into the final analysis. Additional healthcare utilization from January 2006-June 2014 was recorded for 3,158 patients (66%), totaling 12,307 encounters with a median of 3 encounters (IQR: 1-5), and a maximum of 102 encounters. The vast majority of non-admission urgent or procedural visits (96%) and inpatient encounters (93%) occurred in the first year. Of all the additional encounters, 9,769 visits were non-admission urgent or procedural visits (79%) with a median charge of $1,955, and most common type of encounter being elective (46%), followed by medical emergency (29%). Of the remaining 2,538 (21%) inpatient encounters, the mean length of stay was 6 days with median charge of $28,450, and medical emergency (39%) and elective admissions (33%) again being the most common encounter type.
CONCLUSIONS: This analysis encompasses healthcare utilization across the range of TBI severity and numerous hospital systems allowing for a more comprehensive and objective identification of reasons for readmission. This represents an initial step to developing a preventative intervention to manage secondary complications post-injury.
Copyright © 2016. Published by Elsevier Inc.
Language: en |