Primary Care and Brain Injury Physician Utilization for Individuals Living With Chronic Brain Injury

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Public Health

Background:

• Traumatic brain injury (TBI) survivors often require long-term medical management.
• Understanding post-TBI healthcare utilization is crucial for optimizing patient outcomes.

Purpose of the Study:

• To investigate the utilization of primary care physicians (PCPs) and brain injury specialists after TBI.
• To identify reasons for underutilization of specialist care.
• To explore patient preferences for physician types for common TBI-related conditions.

Main Methods:

• Prospective, observational cohort study.
• Involved 1520 participants from 15 TBI Model System centers with TBI 1-35 years prior.
• Assessed current PCP and brain injury physician care, reasons for lack of care, and physician preference for common conditions.

Main Results:

• 85% of participants had a PCP, and 35% received care from a brain injury physician.
• Younger age, male sex, Black race, unmarried status, fewer comorbidities, and faster initial recovery were associated with lacking physician care.
• Lack of perceived need was a primary reason for not seeing a specialist.

Conclusions:

• The majority of TBI survivors maintain primary care, but ongoing specialist care is infrequent.
• Specific demographic and clinical factors predict reduced access to primary and specialty care.
• Targeted interventions may be needed for identified subgroups to ensure comprehensive TBI care.