COST/BENEFIT ANALYSIS FOR POST-ACUTE REHABILITATION OF THE TRAUMATICALLY BRAIN-INJURED PATIENT

Outcome studies related to the post-acute rehabilitation of the traumatically brain injured (TBI) have focused on quality-oflife issues. There has been little attention paid to cost/benefit relationships. Two-hundred-eighteen patients were rated at admission and discharge on the Disability Rating Scale (DRS) and on a living status scale. Costs of care in different living status settings (private living quarters with professional help, long-term care facility, psychiatric hospital, etc.) were obtained and analyzed by the two scales to demonstrate the cost/benefit relationships. The study showed a stafisfically significant benefit and cost savings, over time, for those patients receiving post-acute rehabilitation. These benefits are in addition to improved quality-of-life benefits. In the last ten to twelve years, rehabilitation has seen the introduction and maturation of an entirely new subspecialty: head-injury rehabilitation. Major emphasis has been placed on improving acute medical care for and rehabilitative management of the traumatically brain injured (TBI) patient. Perhaps of equal importance has been the development of post-acute rehabilitation programs for these patients. Nineteen-eighty saw the founding of the National Head Injury Foundation at a time when there existed fewer than one dozen specialty programs for the TBI population. Since that time, NHIF has grown considerably as has the number of specialty programs, some seven hundred-plus across the country.1 Many of these programs are designed to provide "post-acute" rehabilitation services such as "Community Re-entry" or ’q~ransitional Living".2-3,1° While these programs may impact outcome and quality-of-life issues, there has been little attention paid to cost/benefit issues.