Differential Impact of the COVID-19 Pandemic on Health Care Utilization Disruption for Community-Dwelling Individuals With and Without Acquired Brain Injury.
Grace J Kim, Hayejin Kim, Jason Fletcher and 5 others
PMID 34934940WHAT IT FOUND
During the pandemic, people with and without brain injury reported missed or delayed care.
Disruption in care for brain injury or mental health went with lower health-related quality of life. Telehealth was common and generally acceptable, but not for thorough exams.
Key findings
01More than half of participants who had TBI or stroke reported missed or delayed care specific to their diagnosis (53%-54.5%).
02Participants who experienced disruption in care for TBI or stroke had health-related quality-of-life scores 3.59 points lower on a 7-35 scale than those who did not.
03Disruption in mental health care was associated with health-related quality-of-life scores 4.30 points lower on a 7-35 scale.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for SLPs
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What it does not show
The sample was self-selected from social media, flyers, email outreach, and registries, so it may not represent all community-dwelling people with acquired brain injury. Only people with personal technology and internet access could participate. The groups were small and unequal, with 33 participants with traumatic brain injury, 66 with stroke, and 108 without acquired brain injury. Most participants were White and college-educated. Some participants lived outside the United States. The survey was adapted from existing tools because no pandemic brain-injury survey existed at study start. Sample sizes for each care type varied because only participants who reported using that type of care were counted. The authors note selection bias may have affected the better outcomes in the stroke group. The study reports survey associations, not tested therapy outcomes.
The easy way to misread this
Do not conclude that telehealth can replace in-person rehabilitation for brain injury. Participants used telehealth and reported convenience, but they also reported technical difficulties, limited physical examination, and less connection with providers. The study is a self-selected survey and cannot show that missed care caused lower quality of life.