ABSTRACT

Objective: The purpose of this study was to characterize health services utilization among individuals hospitalized with a traumatic brain injury (TBI) 1-year post-injury.

Methods: Using a retrospective cohort design, adult patients (n = 32, 042) hospitalized with a traumatic brain injury between 2005 and 2014 were selected from a statewide traumatic brain injury registry. Data on health services utilization for 1-year post-injury were extracted from electronic medical and administrative records. Descriptive statistics and logistic regression were used to characterize the cohort and a subgroup of superutilizers of health services.

Results: One year after traumatic brain injury, 56% of participants used emergency department services, 80% received inpatient services, and 93% utilized outpatient health services. Superutilizers had ≥3 emergency department visits, ≥3 inpatient admissions, or ≥26 outpatient visits 1-year post-injury. Twenty-six percent of participants were superutilizers of emergency department services, 30% of inpatient services, and 26% of outpatient services. Superutilizers contributed to 81% of emergency department visits, 70% of inpatient visits, and 60% of outpatient visits. Factors associated with being a superutilizer included sex, race, residence, and insurance type.

Conclusions: Several patient characteristics and demographic factors influenced patients’ healthcare utilization post-TBI. Findings provide opportunities for developing targeted interventions to improve patients’ health and traumatic brain injury-related healthcare delivery.

 抽象的

目的：本研究的目的是了解因创伤性脑损伤 (TBI) 住院的个人在受伤后 1 年的医疗服务利用情况。

方法：采用回顾性队列设计，从全州脑外伤登记处选择 2005 年至 2014 年间因脑外伤住院的成年患者 (n = 32, 042)。从电子医疗和行政记录中提取受伤后一年的卫生服务利用数据。使用描述性统计和逻辑回归来描述卫生服务超级利用者的队列和亚组的特征。

结果：脑外伤一年后，56% 的参与者使用急诊科服务，80% 的参与者接受住院服务，93% 的参与者使用门诊医疗服务。超级利用者在受伤后 1 年内有 ≥3 次急诊就诊、≥3 次住院或 ≥26 次门诊就诊。 26% 的参与者是急诊科服务的超级利用者，30% 是住院服务的超级利用者，26% 是门诊服务的超级利用者。超级利用者贡献了 81% 的急诊就诊、70% 的住院就诊和 60% 的门诊就诊。与成为超级利用者相关的因素包括性别、种族、居住地和保险类型。

结论：一些患者特征和人口统计因素影响 TBI 后患者的医疗保健利用。研究结果为制定有针对性的干预措施提供了机会，以改善患者的健康和与创伤性脑损伤相关的医疗服务。