Is the Discharge Destination for Patients with Traumatic Brain Injury Predictive of Recovery?
Traumatic brain injury (TBI) can cause cognitive, behavioral, and physical limitations, and impact an individual’s ability to return to work, reintegrate into the community and live independently.
A new study will undertake a systematic review of the predictive nature of discharge settings following acute care of TBI patients. Researchers believe the results of this review will aid healthcare providers, and TBI patients and their families, in making informed discharge decisions to the next level of care.
What Settings Are Available Discharge Destinations?
Acute care follows emergency treatment after injury. Thereafter, patients are discharged either to home or a rehabilitation facility. Improvement of early medical interventions has increased the survival rate for TBI patients. In turn, this has increased the number of patients with disabilities and to some extent has shifted the focus of research from discharge status following TBI to discharge destination.
An increasing number of patients require inpatient rehabilitation or admission to long-term care facilities with varied available levels of rehabilitation services. At the time of discharge, a wide range of discharge settings are available, including inpatient rehabilitation facilities, skilled nursing facilities, short-term facilities and long term care facilities. There is also the option of returning home with or without support. Thus, there are various levels of rehabilitation care are available to patients with TBI.
What Factors Impact Selections of Discharge Destinations?
Many patients with long lasting impairments would benefit from discharge to a setting that offers rehabilitation services.
Studies have repeatedly shown that intensive inpatient rehabilitation offers greater improvement in cognitive and physical recovery in patients with TBI. But the decision to discharge a TBI patient from acute care to rehabilitation is often based on other factors than clinical need. The cost and different levels of rehabilitation offered by varied facilities are other factors that are considered in determining individual discharge dispositions.
Some studies suggest that discharge to a specific rehabilitation setting merely reflects pre-injury functioning and severity of injury while other studies indicate that demographic and socio-economic factors impact discharge decisions to home as opposed to rehabilitation facilities or institutionalized care.