Disability and return to work outcomes after traumatic brain injury: results from the Washington State Industrial Insurance Fund.
BACKGROUND
This article contains a description of community traumatic brain injury (TBI) treatment patterns and outcomes based solely on workers' compensation administrative records for Washington State.


METHODS
Administrative records available from the Washington State Department of Labor and Industries data warehouse of administrative records are used to describe medical rehabilitation services and return to work (RTW) referrals for cases of TBI between 1 January 1998 and 31 December 2002. These data represent official records for disability determination and referral for vocational rehabilitation (VR) services.


RESULTS
At total of 797 cases were identified all of which had identifiable treatment trajectories. No disability was the outcome in 9.0% of cases; temporary disability in 53.5% of cases, permanent disability in 31.1% of cases. Only 48% of surviving cases include a medical rehabilitation phase. This phase included only inpatient services in 26.5% of referred cases, only ambulatory services in 59.6% and both inpatient and ambulatory services in 13.9%. Only about half of surviving cases were referred for RTW services. Employment rates were similar to those published from other state rehabilitation programs.


CONCLUSIONS
State/community treatment and disability outcome patterns are more diverse than the expected sequence of acute treatment, medical rehabilitation and VR. Employment rates after referral for VR were 65%.
Wrona
Ronald M
RM
Department of Public Health, Western Kentucky University, 4441 Greenacre Drive, Owensboro, KY 42303, USA. ronwrona@roadrunner.com
D000328:Adult; D001930:Brain Injuries / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012017:Referral and Consultation; D012050:Rehabilitation, Vocational; D014861:Washington; D014942:Workers' Compensation / Q000706:statistics & numerical data