Study objective

A better understanding of differences in traumatic brain injury incidence by geography may help inform resource needs for local communities. This paper presents estimates on traumatic brain injury–related hospitalizations and deaths by urban and rural county of residence.

Methods

To estimate the incidence of traumatic brain injury–related hospitalizations, data from the 2017 Healthcare Cost and Utilization Project’s National Inpatient Sample were analyzed (n=295,760). To estimate the incidence of traumatic brain injury–related deaths, the Centers for Disease Control and Prevention’s National Vital Statistics System multiple-cause-of-death files were analyzed (n=61,134). Datasets were stratified by residence, sex, principal mechanism of injury, and age group. Traumatic brain injury–related hospitalizations were also stratified by insurance status and hospital location.

Results

The rate of traumatic brain injury–related hospitalizations was significantly higher among urban (70.1 per 100,000 population) than rural residents (61.0), whereas the rate of traumatic brain injury–related deaths was significantly higher among rural (27.5) than urban residents (17.4). These patterns held for both sexes, individuals age 55 and older, and within the leading mechanisms of injury (ie, suicide, unintentional falls). Among patients with Medicare or Medicaid, the rate of traumatic brain injury–related hospitalizations was higher among urban residents; there was no urban/rural difference with other types of insurance. Nearly all (99.6%) urban residents who were hospitalized for a traumatic brain injury received care in an urban hospital. Additionally, approximately 80.3% of rural residents were hospitalized in an urban hospital.

Conclusion

Urban residents had a higher rate of traumatic brain injury–related hospitalizations, whereas rural residents had a higher rate of traumatic brain injury–related deaths. This disparity deserves further study using additional databases that assess differences in mechanisms of injury and strategies to improve access to emergency care among rural residents.

中文翻译：

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城乡县脑外伤相关住院和死亡人数——2017年

学习目标

A better understanding of differences in traumatic brain injury incidence by geography may help inform resource needs for local communities. This paper presents estimates on traumatic brain injury–related hospitalizations and deaths by urban and rural county of residence.

Methods

为估计创伤性脑损伤相关住院的发生率，分析了 2017 年医疗成本和利用项目全国住院患者样本的数据 (n=295,760)。为估计创伤性脑损伤相关死亡的发生率，对疾病控制和预防中心的国家生命统计系统多死因文件进行了分析 (n=61,134)。数据集按居住地、性别、受伤的主要机制和年龄组进行分层。创伤性脑损伤相关的住院治疗也根据保险状况和医院地点进行分层。

结果

城市居民（每 10 万人中有 70.1 人）的脑外伤相关住院率显着高于农村居民（61.0 人），而农村居民（27.5 人）的脑外伤相关死亡率显着高于城市居民（17.4 人） ). 这些模式适用于男女、55 岁及以上的人，以及主要的伤害机制（即自杀、意外跌倒）。在 Medicare 或 Medicaid 患者中，城市居民与创伤性脑损伤相关的住院率更高；与其他类型的保险没有城乡差异。几乎所有 (99.6%) 因创伤性脑损伤住院的城市居民都在城市医院接受治疗。此外，约80.3%的农村居民在城市医院住院。

结论

城市居民的脑外伤相关住院率较高，而农村居民的脑外伤相关死亡率较高。这种差异值得使用额外的数据库进一步研究，这些数据库评估伤害机制的差异和改善农村居民获得紧急护理的策略。