title: Factors that predict acute hospitalization discharge disposition for adults with moderate to severe traumatic brain injury.
abstract: OBJECTIVE
  To identify factors predicting acute hospital discharge disposition after moderate to severe traumatic brain injury (TBI).
  
  
  METHODS
  Secondary analysis of existing datasets.
  
  
  METHODS
  Acute care hospitals.
  
  
  METHODS
  Adults hospitalized with moderate to severe TBI included in 3 large sets of archival data: (1) Centers for Disease Control and Prevention Central Nervous System Injury Surveillance database (n=15,646); (2) the National Trauma Data Bank (n=52,012); and (3) the National Study on the Costs and Outcomes of Trauma (n=1286).
  
  
  METHODS
  None.
  
  
  METHODS
  Discharge disposition from acute hospitalization to 1 of 3 postacute settings: (1) home, (2) inpatient rehabilitation, or (3) subacute settings, including nursing homes and similar facilities.
  
  
  RESULTS
  The Glasgow Coma Scale (GCS) score and length of acute hospital length of stay (LOS) accounted for 35% to 44% of the variance in discharges to home versus not home, while age and sex added from 5% to 8%, and race/ethnicity and hospitalization payment source added another 2% to 5%. When predicting discharge to rehabilitation versus subacute care for those not going home, GCS and LOS accounted for 2% to 4% of the variance, while age and sex added 7% to 31%, and race/ethnicity and payment source added 4% to 5%. Across the datasets, longer LOS, older age, and white race increased the likelihood of not being discharged home; the most consistent predictor of discharge to rehabilitation was younger age.
  
  
  CONCLUSIONS
  The decision to discharge to home a person with moderate to severe TBI appears to be based primarily on severity-related factors. In contrast, the decision to discharge to rehabilitation rather than to subacute care appears to reflect sociobiologic and socioeconomic factors; however, generalizability of these results is limited by the restricted range of potentially important variables available for analysis.
authors.affiliation: Research Department, Craig Hospital, 3425 S Clarkson St., Englewood CO 80113, USA. JCuthbert@Craighospital.org
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Cuthbert
authors.forename: John D
authors.initials: JD
authors.lastname: Corrigan
authors.forename: Cynthia
authors.initials: C
authors.lastname: Harrison-Felix
authors.forename: Victor
authors.initials: V
authors.lastname: Coronado
authors.forename: Marcel P
authors.initials: MP
authors.lastname: Dijkers
authors.forename: Allen W
authors.initials: AW
authors.lastname: Heinemann
authors.forename: Gale G
authors.initials: GG
authors.lastname: Whiteneck
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000534:rehabilitation*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012737:Sex Factors; D012959:Socioeconomic Factors; D055815:Young Adult