Trends in the Characteristics and Outcomes of Older Medicare Patients With Traumatic Brain Injury Treated in Inpatient Rehabilitation Facilities: 2013 to 2018.
Anne Deutsch, Raj Kumar, Mitch Sevigny and 2 others
PMID 38417777WHAT IT FOUND
Older Medicare patients with recent traumatic brain injury in inpatient rehabilitation increased 28.2% from 2013 to 2018.
They were more often male, had more comorbidities, and more were discharged home.
Key findings
01Older Medicare patients with TBI treated in IRFs increased from 14,657 in 2013 to 18,791 in 2018, a 28.2% increase.
02The analytic sample was 99,804 IRF stays for patients aged 65 and older, coded as first admission and with time since injury no longer than 90 days.
03The percentage discharged home increased from 67.8% to 71.6% between 2013 and 2018.
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
This is a descriptive database analysis, not a controlled trial, so it cannot determine whether inpatient rehabilitation caused the observed changes. The IRF-PAI changed across 2013 to 2018, limiting some year-to-year comparisons. The sample includes only Medicare patients aged 65 and older with first TBI admissions and injury within 90 days who were discharged from an IRF, so it excludes younger patients, later admissions, and people who did not receive IRF care. Discharge destination trends are partly affected by an October 2014 change in the IRF-PAI discharge setting item. IRFs varied in TBI specialization, and not all people with TBI have access to IRF care, so the sample may not represent all older adults with TBI who need rehabilitation. No confidence intervals or significance values were reported.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the rise in older Medicare TBI IRF stays or the score increases as proof that rehabilitation caused better outcomes. This is a descriptive database analysis with changing IRF-PAI items and no significance testing.