Characterizing health care utilization following hospitalization for a traumatic brain injury: a retrospective cohort study.
Johanne Eliacin, Ziyi Yang, Jacob Kean and 1 others
PMID 33356602WHAT IT FOUND
One year after hospitalization for traumatic brain injury, 26% to 30% of patients were superutilizers of emergency, inpatient, or outpatient care.
These patients accounted for 60% to 81% of all visits in those settings. Prior healthcare use and comorbidities strongly predicted this high utilization.
Key findings
01Between 26% and 30% of patients hospitalized for traumatic brain injury were identified as superutilizers of emergency, inpatient, or outpatient services in the year following injury.
02These superutilizers accounted for the majority of healthcare visits, contributing to 81% of emergency department visits, 70% of inpatient visits, and 60% of outpatient services.
03Having used emergency or inpatient services in the year before the brain injury, and having significant comorbidities, were strong predictors of becoming a superutilizer afterwards.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study relied on registry data, which may not capture all cases of traumatic brain injury in the state, potentially limiting how well the results apply to other populations. Data from non-participating facilities and some private outpatient practices were missing, which could understate the total amount of care patients received. The study could not determine if the high healthcare use was driven specifically by the brain injury, its severity, or other unrelated medical conditions and injuries the patient had. Insurance status was recorded only at the time of the initial hospitalization, so changes in coverage during the year were not accounted for. Patients who moved out of state or used services outside the network were lost to follow-up, introducing potential bias.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that high healthcare utilization is caused solely by the traumatic brain injury itself. The study notes that pre-existing comorbidities and prior healthcare use were strong predictors, meaning these patients often had other significant health needs driving their frequent visits.