Description of the moderate brain injured patient and predictors of discharge to rehabilitation.

Abstract Objective To describe patients with moderate traumatic brain injury (TBI) treated and discharged at levels I and II trauma centers in the United States; and to describe the predictors of discharge to rehabilitation after acute care. Design Retrospective, cross-sectional, descriptive study. Setting Trauma centers. Participants Patients with moderate TBI (N=2087; age range, 18–64y) as reported in the 2010 National Sample Project. Interventions None. Main Outcome Measure Discharge destination (rehabilitation vs home with no services). Results Multivariate logistic regression models revealed that demographic, clinical, and financial characteristics influenced the likelihood of being discharged to rehabilitation. Increased age, increased severity, Medicare use, longer length of stay, and trauma center locations in the Midwest and Northeast all increased the likelihood of discharge to rehabilitation. Conclusions The decision to discharge a person with moderate TBI from acute care to rehabilitation appears to be based on factors other than just clinical need. These findings should be considered in creating more equitable access to postacute rehabilitation services for patients with moderate TBI because they risk long-term physical and cognitive problems and have the potential for productive lives with treatment.