Article

A prospective study of 91 consecutive traumatic brain injury
admissions to rehabilitation over a 2-year period to determine factors impacting
on rehabilitation charges. METHODS: Discharge records of 91 adult traumatic brain
injury patients comprising total unsubsidized billings for each completed
inpatient rehabilitation episode were used to derive total charges. Co-variates
analysed included demographic, acute traumatic brain injury and rehabilitation
variables including the Modified Barthel Index score.
RESULTS: The total median
rehabilitation charge per episode was S$7845.50 (range: S$970.55-$44,817.20) [1
Euro=S$2.10]. The top 3 contributory median total charges/episode included bed,
board and nursing (S$5616.00), occupational therapy (S$606.00), and physical
therapy (S$526.00). Patients with lower admission Glasgow Coma Scale scores,
longer post-traumatic amnesia duration, dysphagia and medical complications
during rehabilitation, lower admission Modified Barthel Index scores, longer
acute and rehabilitation length of stay had significantly higher rehabilitation
charges (p<0.001). Using multiple regression analyses, only rehabilitation length
of stay and change in Modified Barthel Index were significantly correlated with
total rehabilitation charges (p<0.001). DISCUSSION: Measures to reduce
rehabilitation length of stay, to prevent medical complications, to facilitate
transfers to rehabilitation, and expedient discharge planning may help to reduce
rehabilitation charges. CONCLUSION: This study has potential implications for
healthcare resource planning for traumatic brain injury rehabilitation.

Langue : ANGLAIS