title: Comorbidity and insurance as predictors of disability after traumatic brain injury.
abstract: OBJECTIVE
  To examine the unique contribution of self-reported medical comorbidity and insurance type on disability after traumatic brain injury (TBI).
  
  
  METHODS
  Inception cohort design at 1-year follow up.
  
  
  METHODS
  A university affiliated rehabilitation hospital.
  
  
  METHODS
  Adults with mild-complicated to severe TBI (N=70).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Self-reported medical comorbidities were measured using the Modified Cumulative Illness Rating Scale, while insurance type was classified as commercial or government-funded; disability was measured using the Disability Rating Scale.
  
  
  RESULTS
  Two models were run using multiple linear regression, and the best-fitting model was selected on the basis of Bayesian information criterion. The full model, which included self-reported medical comorbidity and insurance type, was significantly better fitting than the reduced model. Participants with a longer duration of posttraumatic amnesia, more self-reported medical comorbidities, and government insurance were more likely to have higher levels of disability. Meanwhile, individual organ systems were not predictive of disability.
  
  
  CONCLUSIONS
  The cumulative effect of self-reported medical comorbidities and type of insurance coverage predict disability above and beyond well-known prognostic variables. Early assessment of medical complications and improving services provided by government-funded insurance may enhance quality of life and reduce long-term health care costs.
authors: Department of Psychology, University of Windsor, Windsor, ON, Canada. Electronic address: gardizi@uwindsor.ca.
authors: Elmar
authors: E
authors: Gardizi
authors: Department of Physical Medicine and Rehabilitation, Wayne State University School of Medicine, Detroit, MI.
authors: Robin A
authors: RA
authors: Hanks
authors: Department of Physical Medicine and Rehabilitation, Wayne State University School of Medicine, Detroit, MI.
authors: Scott R
authors: SR
authors: Millis
authors: Touchstone Neurorecovery Center/Nexus Health Systems, Conroe, TX.
authors: Maritza J
authors: MJ
authors: Figueroa
mesh_terms: D000328:Adult; D000647:Amnesia / Q000209:etiology; D001499:Bayes Theorem; D001930:Brain Injuries / Q000145:classification / Q000150:complications*; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D007348:Insurance, Health / Q000145:classification*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D057566:Self Report; D055815:Young Adult
keywords: Comorbidity; Insurance; Rehabilitation; Traumatic brain injury