Relationship of Rehabilitation Insurance Payor to Functional Status at 1 Year Posttraumatic Brain Injury: A Traumatic...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Health Services Research

Background:

• Traumatic brain injury (TBI) significantly impacts long-term functional recovery.
• Insurance status is a critical factor influencing healthcare access and outcomes.
• Understanding the role of insurance in TBI rehabilitation is essential for improving patient care.

Purpose of the Study:

• To investigate the association between insurance status during inpatient rehabilitation and 1-year functional outcomes in moderate to severe TBI survivors.
• To identify specific insurance types linked to poorer functional recovery post-TBI.

Main Methods:

• A multicenter prospective cohort study of 8,285 individuals with moderate to severe TBI.
• Data collected post-inpatient rehabilitation discharge.
• Functional Independence Measure (FIM) motor and cognitive scores assessed at 1-year post-injury.

Main Results:

• Individuals with Medicaid, Medicare (under 65), or workman's compensation/auto insurance had worse 1-year FIM motor and cognitive scores compared to those with private insurance.
• The disparity in outcomes was more pronounced for individuals with longer rehabilitation stays (≥ 30 days).
• Poorer outcomes were observed for those with Medicaid and Medicare (65+) without secondary insurance, particularly with longer rehabilitation stays.

Conclusions:

• Insurance type significantly influences 1-year functional outcomes following moderate to severe TBI.
• Public insurance and workman's compensation/auto insurance are associated with relatively poorer functional outcomes.
• Interventions focusing on social work, care coordination, and resource facilitation may be beneficial for individuals with public insurance or workman's compensation.