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Between 2013 and 2018, the number of Medicare beneficiaries with traumatic brain injury (TBI) who were treated in inpatient rehabilitation facilities increased by 28%, according to a new study published in the Archives of Physical Medicine and Rehabilitation.
Researchers led by Anne Deutsch, PhD, RN, a research scientist in the Center for Rehabilitation Outcomes Research at Shirley Ryan AbilityLab, looked at data for 99,804 Medicare fee-for-service and Medicare Advantage patients aged 65 and older with TBI treated in inpatient rehabilitation facilities between 2013 and 2018. Data included sociodemographic and clinical characteristics, length of stay, cognitive and motor functional ability upon admission and discharge, discharge destination, and other rehabilitation outcomes.
The 28% increase in the number of Medicare beneficiaries treated in inpatient rehabilitation facilities in the US due to a TBI can’t be entirely explained by an increase in the number of people 65 years old and older, explains Deutsch, who is also a senior research public health analyst at RTI International. “The actual increase in population among people 65 and older during this time was only 16.9%, so there are really just more people experiencing these traumatic brain injury – more falls, more car crashes, more of the kinds of events that lead to these injuries. And this has implications for the kind of care being provided. One takeaway is that we need more specialists who treat TBI,” says Deutsch.
The researchers also found that between 2013 and 2018:
- The percentage of males increased slightly from 52.9% to 54.8%
- There was a higher percentage of patients with tiered comorbidities
- There was a decrease in variability of length of stay
- There was a slightly better self-care and mobility improvement
- There was a higher percentage of patients discharged to the community (67.8% in 2013 and 71.6% in 2018)
- Newer data showed that prior to injury, more than one third used a walker and more than three quarters had a history of recent falls
Raj Kumar, PhD, MPH, Ichan School of Medicine at Mount Sinai; Mitch Sevigny, Craig Hospital; John Potelle, RTI International and Tara McMullen, Centers for Medicare & Medicaid Services are co-authors.
The research was funded in part by the National Institute on Disability, Independent Living and Rehabilitation Research (grants 90DP0013 and 90DPTB0018), the Centers for Medicare & Medicaid Services (contract HHSM-500-2013-13015I), RTI International, and National Institute of Health’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant K99HD106060).