Abstract
Objective: To determine whether financial compensation modifies long-term mortality following severe traumatic brain injury.
Methods: Data from consecutive adult discharges from three metropolitan, inpatient brain injury rehabilitation services of the New South Wales Brain Injury Rehabilitation Programme for first episode TBI were analysed with respect to the impact of compensation status on long-term mortality.
Results: Overall, subjects had a 4:1 male:female ratio with a mean age of 35 years. All cases for whom data were available experienced severe, very severe or extremely severe injuries using standardized PTA assessment. The median length of rehabilitation stay was 37 days and 74% of participants returned home following rehabilitation. While the mean discharge FIM score was 104, 32% of people required moderate or maximal assistance with activities of daily living. Compensation data were available for 1851 (73%) of the 2545 participants eligible for the study. Eight hundred and twenty-six (45%) people within this cohort received financial compensation in addition to universal healthcare (Australian Medicare). Univariate Cox regression analysis suggested that compensation following TBI provided asignificant protective factor against late mortality (HR¼0.66, 95%CI¼0.51–0.87). Hazard ratios and 95% CIs were undertaken for three multivariate Cox regression models, examining (1) all variables known to influence late mortality, (2) non-modifiable factors such as demographic and injury related factors and (3) rehabilitation service variables that were potentially modifiable through compensation. Of these models, receipt of compensation showed a protective trend with rehabilitation service variables that approached statistical significance (HR¼0.75; 95% CI¼0.55–1.03). Functional dependence(based on discharge FIM) and discharge to a care facility remained significant risk factors for late mortality in this model.
Conclusions: At the time of discharge from rehabilitation, receipt of compensation was associated with reduced mortality risk, with functional dependence and discharge to a care facility remaining significant risk factors for late mortality.
Methods: Data from consecutive adult discharges from three metropolitan, inpatient brain injury rehabilitation services of the New South Wales Brain Injury Rehabilitation Programme for first episode TBI were analysed with respect to the impact of compensation status on long-term mortality.
Results: Overall, subjects had a 4:1 male:female ratio with a mean age of 35 years. All cases for whom data were available experienced severe, very severe or extremely severe injuries using standardized PTA assessment. The median length of rehabilitation stay was 37 days and 74% of participants returned home following rehabilitation. While the mean discharge FIM score was 104, 32% of people required moderate or maximal assistance with activities of daily living. Compensation data were available for 1851 (73%) of the 2545 participants eligible for the study. Eight hundred and twenty-six (45%) people within this cohort received financial compensation in addition to universal healthcare (Australian Medicare). Univariate Cox regression analysis suggested that compensation following TBI provided asignificant protective factor against late mortality (HR¼0.66, 95%CI¼0.51–0.87). Hazard ratios and 95% CIs were undertaken for three multivariate Cox regression models, examining (1) all variables known to influence late mortality, (2) non-modifiable factors such as demographic and injury related factors and (3) rehabilitation service variables that were potentially modifiable through compensation. Of these models, receipt of compensation showed a protective trend with rehabilitation service variables that approached statistical significance (HR¼0.75; 95% CI¼0.55–1.03). Functional dependence(based on discharge FIM) and discharge to a care facility remained significant risk factors for late mortality in this model.
Conclusions: At the time of discharge from rehabilitation, receipt of compensation was associated with reduced mortality risk, with functional dependence and discharge to a care facility remaining significant risk factors for late mortality.
| Original language | English |
|---|---|
| Pages | 653-653 |
| Number of pages | 1 |
| Publication status | Published - 2014 |
| Event | Tenth World Congress on Brain Injury - Hyatt Embarcadero, San Francisco, United States Duration: 19 Mar 2014 → 22 Mar 2014 http://www.internationalbrain.org/news/news/tenth-world-congress-on-brain-injury-news/ (Conference website) |
Conference
| Conference | Tenth World Congress on Brain Injury |
|---|---|
| Country/Territory | United States |
| City | San Francisco |
| Period | 19/03/14 → 22/03/14 |
| Other | Held biennially, IBIA World Congress is the largest gathering of international professionals working in the field of brain injury. Delegates are comprised of physicians, psychologists and neuropsychologists, therapists, social workers, nurses, case managers, legal professionals, advocates and all others working in the field of brain injury. Over 1400 multidisciplinary professionals attended our last Congress in Edinburgh, Scotland in 2012. The Congress program will feature internationally recognized invited speakers, platform lectures, workshops, short oral presentations and poster sessions. The theme of the congress will be Neurotrauma, Technology, and Neurorehabilitation. The aim of the Tenth World Congress is to provide an opportunity for establishing collegial relationships with international professionals focused on the care and/or service of persons with acquired brain injury and/or the science of brain injury research. State of the art research will be presented dealing with information spanning from basic science to clinical (coma to community) aspects of brain injury. Finally, the Congress seeks to provide didactic opportunities for clinicians interested in advancing their knowledge in brain injury science, medicine and care. The official language of the Congress is English, and sessions are open to all delegates registering to attend the event. |
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