Charges and lengths of stay for acute and inpatient rehabilitation treatment of traumatic brain injury 1990–1996

Abstract

This investigation evaluated yearly trends in charges and lengths of stay for patients with brain injury in acute care and rehabilitation settings over a 7 year period. Data was collected from 800 consecutive patients enrolled in four NIDRR Model Systems Traumatic Brain Injury programmes. Acute care daily charges showed almost routine increases, averaging nearly $550 per year. Conversely, lengths of stay generally showed a downward trend, with annual reductions averaging 2.25 days. Admission lengths of stay averaged 22-29 days between 1990-1994. Admissions averaged less than 20 days beginning in 1995, with the 1996 average of 16 days, nearly half that of the 1993 average. Between 1990-1996, average daily rehabilitation charges increased each year, with the rise averaging $83 or 7%. The rise in daily rehabilitation charges was offset by corresponding decreases in lengths of stay averaging 3.65 days or 8% annually. Increases in daily charges for brain injury rehabilitation care were roughly comparable to those for general medical care prices. However, the rate of change in acute care charges was substantially greater, with annual increases averaging 10% more than national medical care prices. The steady downward trend in lengths of stay raises serious concerns about the future availability of health care services to persons with brain injury.

Cost-benefits associated with social outcome from neurobehavioural rehabilitation

“…The present paper followed accepted practice in using length of stay as a means of estimating treatment costs [57]. There is evidence to suggest that increases in rehabilitation charges may be responsible for shorter lengths of stay [58] in which case the argument that post-acute rehabilitation offers 'little or no financial risk' to payers [29] is not being heard. On this basis there is clearly a need for closer dialogue between funding agencies and service providers [59] to establish common objectives.…”

A Telehealth Approach to Caregiver Self-Management Following Traumatic Brain Injury

“…The median number of study calls for caregivers in the treatment group (including those who withdrew from the intervention as per the intent-to-treat analysis) was 7 (intraquartile range, [3][4][5][6][7][8][9]. The frequency of the types of caregiver issues addressed in the calls can be seen Table 2.…”

Delta–alpha ratio correlates with level of recovery after neurorehabilitation in patients with acquired brain injury

“…The rehabilitation of these disorders is normally lengthy and costly (Domínguez-Morales et al, 1999;Kreutzer et al, 2001;Galindo-Lucas et al, 2001). One of the main worries of these patients' families is the duration and efficacy of rehabilitation programs.…”