Discharge destination from acute care after traumatic brain injury.
OBJECTIVE
To identify the impact of private insurance coverage on discharge disposition after a traumatic brain injury (TBI) using injury in a motor vehicle accident (MVA) as a proxy for private insurance, controlling for age and severity of injury.


METHODS
Cross-sectional study.


METHODS
Patients with TBI discharged between 1993-1994 and 2000-2001 (n = 9,703).


METHODS
Discharge destination from acute care; controlled odds ratio (OR) and confidence interval (CI) for type of injury.


RESULTS
Type of injury, age, and length of stay are significantly associated with discharge destination. However, the motor vehicle accident patients are 56% more likely to be discharged to home with support services than patients with similar injuries from falls.


CONCLUSIONS
Even in a system with universal coverage, availability of private insurance type is a potential independent determinant of post-acute care services. More research is required to determine the effect this relationship has on the cost and outcomes of care for TBI patients.
Graduate Department of Rehabilitation Science, University of Toronto, Toronto, ON, Canada.
Hwan
H
Kim
Angela
A
Colantonio
Raisa
R
Deber
Lee
L
Vernich
D000058:Accidental Falls; D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000359:Aftercare / Q000706:statistics & numerical data*; D000367:Age Factors; D001930:Brain Injuries / Q000191:economics* / Q000209:etiology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007902:Length of Stay; D008134:Long-Term Care; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012047:Rehabilitation Centers