Article Text

PDF

20
DIFFERENTIATING PATTERNS OF HEALTH SERVICE USE FOLLOWING SEVERE TRAUMATIC BRAIN INJURY: AN IDIOGRAPHIC ANALYSIS
  1. A Collie1,2,
  2. K Prang1
  1. 1Institute for Safety Compensation and Recovery Research, Monash University, Australia
  2. 2Department of Epidemiology and Preventive Medicine, Monash University, Australia

    Abstract

    Background Traumatic Brain Injury (TBI) can result in lifelong physical and behavioural impairments that necessitate long-term access to healthcare services. Provision of health services to those with severe TBI is a major cost for health and injury compensation systems. Statistical trajectory modelling allows differentiation of patterns of health service utilisation (HSU) following TBI.

    Objective To differentiate and describe patterns of HSU following severe TBI.

    Method Detailed sub-acute HSU data for 316 cases of adult severe TBI (GCS 3–8) was extracted from the injury compensation database of the Transport Accident Commission in Victoria, Australia. Data comprised of monthly observation counts of HSU over the 60-month period post injury. A semi-parametric group-based trajectory analytical technique for longitudinal data was used to identify distinct clusters of participant trajectories.

    Results Four patterns of HSU trajectory were identified. Group 1 (27% of participants) displayed a rapid decrease in HSU in the first 12 months post injury which stabilised to an average of 1–2 services per month thereafter. Group 2 (24%) had a sharp peak in HSU post-injury (25–36 services per month) and a gradual decline over time. Group 3 (32%) displayed a peak in the first months post injury (16–25 services per month), and then a very slow decline. Group 4 (17%) displayed a steady rise from 16 to 36 services per month, and then a gradual decrease in the final 2 years.

    Significance Idiographic analysis of subacute HSU using trajectory modelling allows differentiation of distinct patterns of HSU following severe TBI. Such analysis may aid health system resource planning and management.

    Statistics from Altmetric.com

    Request permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.