The evidence for the cost-effectiveness of rehabilitation following acquired brain injury

Turner-Stokes, Lynne

doi:10.7861/clinmedicine.4-1-10

Cited by 25 publications

(21 citation statements)

References 11 publications

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“…These results are similar to the findings in a previous study by Turner-Stokes and colleagues. 16,17 In that analysis, in the high-dependency group, the weekly cost of care fell by an average of £639, and the cost of inpatient rehabilitation was covered by these cost savings in 16.3 months. Rehabilitation in the group who were deemed either independent or independent in a special environment on admission was less cost effective than that in the more dependent group.…”

Section: Discussionmentioning

confidence: 99%

Cost effectiveness of inpatient rehabilitation in patients with brain injury

Cooney

Carroll

2016

Clinical Medicine

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Rehabilitation following acquired brain injury improves health outcomes, reduces disability, and improves quality of life. We assessed the cost effectiveness of inpatient rehabilitation after brain injury in individuals with brain injury admitted to the Irish national tertiary specialist rehabilitation centre in 2011. Patients' score on the Disability Rating Scale (DRS) was recorded on admission and at discharge after intensive inpatient rehabilitation. Cost savings attributed to the rehabilitation programme were calculated as the difference between direct care costs on admission and discharge. Direct costs of care were calculated as the weekly cost of the care-assistant hours required to care for patients on the basis of their level of disability or daily nursing-home bed cost when this was required. Of 63 patients, complete DRS information for admission and discharge was available for 41. DRS scores, and therefore average levels of functioning, differed signifi cantly at admission (2.3, between mildly and moderately dependent) and discharge (1.1, independent in special environments, p<0.01). Average weekly care costs fell from €629 to €242, with costs recouped within 30 months. Thus, substantial savings result from inpatient rehabilitation, and these savings could have been greater had we considered also the economic benefi t of enabling patients to return to employment.

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Section: Discussionmentioning

confidence: 99%

Cost effectiveness of inpatient rehabilitation in patients with brain injury

Cooney

Carroll

2016

Clinical Medicine

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“…Various studies suggest that the majority of clients are male and aged between 15 and 35 who have suffered injury from falls, road accidents or alcohol related incidents [4,5]. Therapy is time-consuming and expensive [2,6,7] and, in a period of great pressure on cost, an inpatient rehabilitation service centre must be able to provide empirical evidence of the efficacy of its treatment and so justify continued funding, especially at times of budget cuts.…”

Section: Introductionmentioning

confidence: 99%

Increase in functional abilities following a residential educational and neurorehabilitation programme in young adults with acquired brain injury

Foy¹,

Somers

2013

NRE

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OBJECTIVES: To characterize and determine the pre-injury and injury-related variables that are linked to the extent of functional recovery following rehabilitation at a mixed therapy and educational residential programme and whether these variables differ for traumatic brain injury (TBI) and non traumatic brain injury (nonTBI). METHODS: 106 young adults (age 16-36 years) with moderate-to-severe TBI who had attended and been discharged from the centre since 2002 were included. Clients received 5 hours of education and/or therapy each day. Functional level was assessed using the FIM + FAM. Regression analysis was used to determine possible predictors of functional independence at discharge. MAIN OUTCOMES AND RESULTS: Clients with TBI and nonTBI made clinically and statistically significant improvements in their functional abilities during their neurorehabilitation. For the combined TBI and nonTBI group, FIM + FAM scores at discharge were predicted by FIM + FAM at admission and length of stay. These two predictors explained 80% of the variance in the FIM + FAM score at discharge. CONCLUSION: Both clients with TBI and nonTBI benefited from a mixed inpatient neurorehabilitation programme. This benefit was predicted by their functional abilities at admission and the length of stay. These findings are of importance as it becomes increasingly necessary to demonstrate who will benefit from residential intensive neurorehabilitation as opposed to community therapy.

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“…This ethical quandary is further compounded by the growing body of treatment evidence in related fields such as stroke rehabilitation. Additionally, even with developing TBI treatment RCTs and mounting observational evidence, such information is only effective when combined with the professional judgment and skill to make use of the research findings with any specific program participant [32][33][34].…”

Section: Challenges Of Randomized Controlled Trialsmentioning

confidence: 99%

“…The length of time wherein the benefits of postacute rehabilitation may manifest themselves may be longer than the time most research grants fund or most researchers are able to endure. Additionally, RCTs are often plagued by small sample sizes due to recruitment challenges and availability of the defined TBI population for the CIR intervention being examined [32][33].…”

Section: Challenges Of Randomized Controlled Trialsmentioning

confidence: 99%

Community-integrated brain injury rehabilitation: Treatment models and challenges for civilian, military, and veteran populations

Trudel

Nidiffer²,

Barth³

2007

JRRD

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Abstract-Traumatic brain injury (TBI) is a major health problem in civilian, military, and veteran populations. Individuals experiencing moderate to severe TBI require a continuum of care involving acute hospitalization and postacute rehabilitation, including community reintegration and, one would hope, a return home to function as a productive member of the community. In the military, the goal is to help individuals with TBI return to active duty or make an optimal return to civilian life if the extent of their injuries necessitates a "medical board" discharge. Whether civilian, military, or veteran with TBI, individuals who move beyond the need to live in a facility must be reintegrated back into the community. This article discusses four treatment models for community reintegration, reviews treatment standardization and outcome issues, and describes a manualized rehabilitation pilot program designed to provide community reintegration and return to duty/work for civilians, veterans, and military personnel with TBI.

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The evidence for the cost-effectiveness of rehabilitation following acquired brain injury

Cited by 25 publications

References 11 publications

Cost effectiveness of inpatient rehabilitation in patients with brain injury

Cost effectiveness of inpatient rehabilitation in patients with brain injury

Increase in functional abilities following a residential educational and neurorehabilitation programme in young adults with acquired brain injury

Community-integrated brain injury rehabilitation: Treatment models and challenges for civilian, military, and veteran populations

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