Abstract
Objective: To describe the characteristics and outcomes of older (65+) Medicare beneficiaries with traumatic brain injury (TBI) treated in inpatient rehabilitation facilities between 2013 and 2018. Design: Descriptive study using IRF Patient Assessment Instrument (IRF-PAI) data reporting trends of the sociodemographic and clinical characteristics and outcomes of inpatient rehabilitation facilities Medicare patients with TBI. Setting: Inpatient rehabilitation facilities in the United States. Participants: 99,804 older Medicare fee-for-service and Medicare Advantage patients with TBI (N=99,804). Interventions: Not applicable. Main Outcome Measures: Length of stay, self-care, and mobility functional outcomes, discharge destination. Results: The number of older Medicare beneficiaries with TBI treated in inpatient rehabilitation facilities increased from 14,657 in 2013 to 18,791 in 2018, an increase of 28.2%. In addition to this overall increase in patients, we also found the percentage of men increased slightly (52.9% to 54.8%), there was a higher percentage of patients with tier 3 comorbidities, there was a decrease in the variability of length of stay, there was slightly more self-care and mobility improvement and a slightly higher percentage of patients discharged to the community (67.8% in 2013 and 71.6% in 2018). Newer standardized data showed that prior to the injury, more than one-third used a walker and more than three-quarters had a history of recent falls. Conclusions: Between 2013 and 2018, the number of Medicare beneficiaries with TBI treated in IRFs increased by approximately 28%. The characteristics of IRF older patients with TBI changed between 2013 and 2018 toward a slightly higher proportion of men, more comorbidities, and a higher percentage being discharged home after inpatient rehabilitation.
Original language | English (US) |
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Pages (from-to) | 1058-1068 |
Number of pages | 11 |
Journal | Archives of physical medicine and rehabilitation |
Volume | 105 |
Issue number | 6 |
DOIs | |
State | Published - Jun 2024 |
Funding
The work was funded in part by the National Institute on Disability, Independent Living and Rehabilitation Research (grants: 90DP0013 and 90DPTB0018), the Centers for Medicare & Medicaid Services (contract: HHSM-500-2013-13015I), RTI International, and National Institute of Health's Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant: K99HD106060). The work was funded in part by the National Institute on Disability, Independent Living and Rehabilitation Research (grants: 90DP0013 and 90DPTB0018 ), the Centers for Medicare & Medicaid Services (contract: HHSM-500-2013-13015I ), RTI International, and National Institute of Health's Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant: K99HD106060 )
Keywords
- Brain injury
- Mobility
- Outcomes
- Rehabilitation
- Self-care
ASJC Scopus subject areas
- Physical Therapy, Sports Therapy and Rehabilitation
- Rehabilitation