Is there equity in long-term healthcare utilization after traumatic brain injury?
OBJECTIVE
To quantify the long-term use of various types of healthcare services in patients with traumatic brain injury and to estimate the relative contribution of predisposing characteristics, enabling factors and health-related needs to determine whether there is equity in healthcare utilization.


METHODS
Cross-sectional study.


METHODS
Seventy-nine non-institutionalized moderate to severe patients with traumatic brain injury (age range 16-67 years).


METHODS
Healthcare use was measured at 3-5 years post-injury. The relative contribution of predisposing characteristics, enabling factors, and health-related needs to the utilization of various types of care was analysed using logistic regression to determine whether there was equity in healthcare utilization.


RESULTS
At least one healthcare service was used by 68% of the patients. Health-related needs explained most of the utilization. However, predisposing characteristics were also related to the use of other medical care and supportive care. Patients with a high internal locus of control were more likely to be users of supportive care, and patients with a high locus of control with the physician were more likely to visit medical specialists.


CONCLUSIONS
The results suggest that most of our patients who needed care, received care. However, inequity could not be ruled out completely as predisposing characteristics also contributed to some types of healthcare utilization.
Willemse-van Son
Agnes H P
AH
Department of Rehabilitation Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands. a.vanson-willemse@erasmusmc.nl
Ribbers
Gerard M
GM
Stam
Henk J
HJ
van den Bos
Geertrudis A M
GA
D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D008134:Long-Term Care / Q000592:standards / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care; D012959:Socioeconomic Factors; D055815:Young Adult