Impact of Minority Status on Functional Outcome and Community Integration Following Traumatic Brain Injury

Rosenthal, Mitchell; Dljkers, Marcel; Harrison-Felix, Cynthia; Nabors, Nina A.; Witol, Adrienne D.; Young, Mary Ellen; Englander, Jeffrey

doi:10.1097/00001199-199610000-00005

Cited by 114 publications

(73 citation statements)

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“…A growing literature suggests ethnic disparities in the incidence of TBI and its outcomes. In the United States, ethnic minority groups are at disproportionate risk of TBI, have higher post-TBI mortality rates [14][15][16] , and have reduced social integration [17] and employment at 1 year [18,19] . Compared to Caucasians, minority groups receive less medical care following TBI (e.g.…”

Section: Discussionmentioning

confidence: 99%

Trends in Head Injury Incidence in New Zealand: A Hospital-Based Study from 1997/1998 to 2003/2004

2008

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Traumatic brain injury (TBI) is a leading cause of disability and death in young adults. Globally, the incidence of TBI hospitalizations is estimated at 200–300 people per 100,000 annually. Using a national health database, we examined the incidence of TBI-related hospital discharges (including 1-day stays) to New Zealand Hospitals from 1997/1998 to 2003/2004. Crude annual hospital-based incidence rates for the total population ranged from 226.9 per 100,000 in 1998/1999 to a high rate of 349.2 in 2002/2003. There was a noticeable increase in rates with the change from ICD-9 to ICD-10 diagnostic codes and there was also disparity in incidence rates according to ethnicity, age and gender. Crude annual hospital-based incidence rates for males and females in Maori (689/100,000 and 302.8/100,000 person-years) and Pacific Island populations (582.6/100,000 and 217.6/100,000 person-years) were much higher than those for the remaining population (435.4/100,000 and 200.9/100,000 person-years), particularly for males. The overall age-standardized hospital- based incidence rate for 2003/2004 was 342 per 100,000 per year (95% CI = 337–349/100,000), and 458 per 100,000 per year for Maori (95% CI = 438–479/100,000) with Maori males experiencing a peak in incidence between 30 and 34 years of age that was not evidenced for the wider population. Standardized hospital-based incidence rates for the total population and for Maori by age, gender and ICD-10 diagnostic codes are also examined.

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Section: Discussionmentioning

confidence: 99%

Trends in Head Injury Incidence in New Zealand: A Hospital-Based Study from 1997/1998 to 2003/2004

2008

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“…To enhance sample representativeness, standardized protocols provide for the inclusion of individuals with a history of prior brain injury, pre-existing neurological condition, or substance abuse. Demographic features of patients included in the model systems database have been described elsewhere [29,30]. Patients were, on average, 35.89 years of age with a standard deviation of 15.73 years.…”

Section: Study Samplementioning

confidence: 99%

Charges and lengths of stay for acute and inpatient rehabilitation treatment of traumatic brain injury 1990–1996

et al. 2001

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This investigation evaluated yearly trends in charges and lengths of stay for patients with brain injury in acute care and rehabilitation settings over a 7 year period. Data was collected from 800 consecutive patients enrolled in four NIDRR Model Systems Traumatic Brain Injury programmes. Acute care daily charges showed almost routine increases, averaging nearly $550 per year. Conversely, lengths of stay generally showed a downward trend, with annual reductions averaging 2.25 days. Admission lengths of stay averaged 22-29 days between 1990-1994. Admissions averaged less than 20 days beginning in 1995, with the 1996 average of 16 days, nearly half that of the 1993 average. Between 1990-1996, average daily rehabilitation charges increased each year, with the rise averaging $83 or 7%. The rise in daily rehabilitation charges was offset by corresponding decreases in lengths of stay averaging 3.65 days or 8% annually. Increases in daily charges for brain injury rehabilitation care were roughly comparable to those for general medical care prices. However, the rate of change in acute care charges was substantially greater, with annual increases averaging 10% more than national medical care prices. The steady downward trend in lengths of stay raises serious concerns about the future availability of health care services to persons with brain injury.

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“…Fifth, an individual's score can be adversely affected by their level of premorbid participation (e.g., if they never did household chores), need for less supervision, and/or availability of the activity or need for participation in the activity (e.g., child care) [36,38,42]. Sixth, demographic factors and cultural values can influence the findings, but no controls are included for these effects in scoring or normative development [43][44][45][46][47]. Seventh, although the sensitivity of this assessment tool's ability to distinguish individuals with and without disability is well established, it is less able to detect change as the result of an intervention [40].…”

Section: Community Integration Questionnairementioning

confidence: 99%

Measurement of social participation outcomes in rehabilitation of veterans with traumatic brain injury

Stiers¹,

Carlozzi²,

Cernich³

et al. 2012

JRRD

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Abstract-Traumatic brain injury (TBI) is a significant concern in the veteran population, and the Department of Veteran Affairs (VA) has devoted substantial healthcare resources to the rehabilitation of veterans with TBI. Evaluating the outcomes of these rehabilitation activities requires measuring whether they meaningfully improve veterans' lives, especially with regard to community and vocational participation, which are strongly linked to perceived quality of life. In January 2010, the VA Rehabilitation Research and Development Service convened an invitational conference focused on outcome measurement in rehabilitation with a specific focus on veterans' community and vocational participation. This article reports on the working group, addressing the issues of conceptualizing and operationalizing such participation outcome measures for veterans with TBI; we discuss conceptual models of participation, review participation subdomains and their instruments of measurement, and identify current research issues and needs. Two avenues are identified for advancing participation measurement in veterans with TBI. (cont) Abstract-research within the VA healthcare system. Second, we describe recommendations for future VA research funding initiatives specific to improving the measurement of participation in veterans with TBI.

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Impact of Minority Status on Functional Outcome and Community Integration Following Traumatic Brain Injury

Cited by 114 publications

References 0 publications

Trends in Head Injury Incidence in New Zealand: A Hospital-Based Study from 1997/1998 to 2003/2004

Trends in Head Injury Incidence in New Zealand: A Hospital-Based Study from 1997/1998 to 2003/2004

Charges and lengths of stay for acute and inpatient rehabilitation treatment of traumatic brain injury 1990–1996

Measurement of social participation outcomes in rehabilitation of veterans with traumatic brain injury

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