Measuring unmet needs and services among persons with traumatic brain injury.
OBJECTIVE
(1) To develop a comprehensive list of needs and services appropriate for persons with traumatic brain injury (TBI); (2) to determine whether these needs and services formed unidimensional hierarchies from least common to most common; (3) to describe the relationship between unmet needs and services received; and (4) to estimate the extent to which a variety of demographic, injury, and service characteristics predict unmet needs.


METHODS
Statewide mailed survey.


METHODS
Illinois communities.


METHODS
A total of 895 persons who had had a TBI recruited from Brain Injury Association members and rehabilitation service recipients. The median time post-TBI was 7 years; the median age was 37 years.


METHODS
Not applicable.


METHODS
A 27-item instrument assessing service needs and utilization of services, and equal-interval measures of needs and services derived with Rasch analysis.


RESULTS
The most prevalent unmet needs were improving memory or problem-solving skills (51.9%), increasing income (50.5%), and improving job skills (46.3%). The instrument defined unidimensional and reliable constructs of needs and services. Persons with greater unmet needs tended to receive fewer services; to report lower life satisfaction and worse medical health and psychologic well-being since injury; to be younger, single, black, dependent in 1 or more daily activities; and to have more recent injuries.


CONCLUSIONS
The results show the common pattern of unmet needs and services and emphasize the importance of comprehensive, statewide assessment of services and needs in developing policies.
Heinemann
Allen W
AW
Department of Physical Medicine and Rehabilitation and Institute for Health Services Research and Policy Studies, Northwestern University, Chicago, IL, USA. a-heinemann@northwestern.edu
Sokol
Kara
K
Garvin
Lauree
L
Bode
Rita K
RK
D000328:Adult; D001930:Brain Injuries / Q000534:rehabilitation*; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male