Article

OBJECTIVE: To ascertain the degree of variation, by state of hospitalization, in
outcomes associated with traumatic brain injury (TBI) in a pediatric population.
DESIGN: A retrospective cohort study of pediatric patients admitted to a hospital
with a TBI. SETTING: Hospitals from states in the United States that voluntarily
participate in the Agency for Healthcare Research and Quality's Healthcare Cost
and Utilization Project. PARTICIPANTS: Pediatric (age </= 19 y) patients
hospitalized for TBI (N=71,476) in the United States during 2001, 2004, 2007, and
2010. INTERVENTIONS: None.
MAIN OUTCOME MEASURES: Primary outcome was proportion
of patients discharged to rehabilitation after an acute care hospitalization
among alive discharges. The secondary outcome was inpatient mortality. RESULTS:
The relative risk of discharge to inpatient rehabilitation varied by as much as
3-fold among the states, and the relative risk of inpatient mortality varied by
as much as nearly 2-fold. In the United States, approximately 1981 patients could
be discharged to inpatient rehabilitation care if the observed variation in
outcomes was eliminated. CONCLUSIONS: There was significant variation between
states in both rehabilitation discharge and inpatient mortality after adjusting
for variables known to affect each outcome. Future efforts should be focused on
identifying the cause of this state-to-state variation, its relationship to
patient outcome, and standardizing treatment across the United States.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.
- Etats Unis

Langue : ANGLAIS