title: Patterns of post-acute health care utilization after a severe traumatic brain injury: Results from the PariS-TBI cohort.
abstract: OBJECTIVE
  To assess brain injury services utilization and their determinants using Andersen's model.
  
  
  METHODS
  Prospective follow-up of the PariS-TBI inception cohort. Out of 504 adults with severe traumatic brain injury (TBI), 245 survived and 147 received a 4-year outcome assessment (mean age 33 years, 80% men). Provision rates of medical, rehabilitation, social and re-entry services and their relations to patients' characteristics were assessed.
  
  
  RESULTS
  Following acute care discharge, 78% of patients received physiotherapy, 61% speech/cognitive therapy, 50% occupational therapy, 41% psychological assistance, 63% specialized medical follow-up, 21% community re-entry assistance. Health-related need factors, in terms of TBI severity, were the main predictors of services. Provision of each therapy was significantly associated with corresponding speech, motor and psychological impairments. However, care provision did not depend on cognitive impairments and cognitive therapy was related to pre-disposing and geographical factors. Community re-entry assistance was provided to younger and more independent patients.
  
  
  CONCLUSIONS
  These quantitative findings illustrate strengths and weaknesses of late brain injury care provision in urban France and highlight the need to improve treatment of cognitive impairments.
authors: APHP, Hôpital Raymond Poincaré, Service de Médecine Physique et de Réadaptation , Garches , France .
authors: Claire
authors: C
authors: Jourdan
authors: Eleonore
authors: E
authors: Bayen
authors: Emmanuelle
authors: E
authors: Darnoux
authors: Idir
authors: I
authors: Ghout
authors: Sylvie
authors: S
authors: Azerad
authors: Alexis
authors: A
authors: Ruet
authors: Claire
authors: C
authors: Vallat-Azouvi
authors: Pascale
authors: P
authors: Pradat-Diehl
authors: Philippe
authors: P
authors: Aegerter
authors: Jean-Jacques
authors: JJ
authors: Weiss
authors: Philippe
authors: P
authors: Azouvi
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000534:rehabilitation / Q000628:therapy*; D003072:Cognition Disorders / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D020127:Recovery of Function; D016896:Treatment Outcome
keywords: Brain injuries; cohort studies; health services research; healthcare surveys; rehabilitation; vocational rehabilitation