Comorbidity and insurance as predictors of disability after traumatic brain injury.
Arch Phys Med Rehabil
; 95(12): 2396-401, 2014 Dec.
Article
em En
| MEDLINE
| ID: mdl-24972339
ABSTRACT
OBJECTIVE:
To examine the unique contribution of self-reported medical comorbidity and insurance type on disability after traumatic brain injury (TBI).DESIGN:
Inception cohort design at 1-year follow up.SETTING:
A university affiliated rehabilitation hospital.PARTICIPANTS:
Adults with mild-complicated to severe TBI (N=70). INTERVENTION Not applicable. MAIN OUTCOMEMEASURES:
Self-reported medical comorbidities were measured using the Modified Cumulative Illness Rating Scale, while insurance type was classified as commercial or government-funded; disability was measured using the Disability Rating Scale.RESULTS:
Two models were run using multiple linear regression, and the best-fitting model was selected on the basis of Bayesian information criterion. The full model, which included self-reported medical comorbidity and insurance type, was significantly better fitting than the reduced model. Participants with a longer duration of posttraumatic amnesia, more self-reported medical comorbidities, and government insurance were more likely to have higher levels of disability. Meanwhile, individual organ systems were not predictive of disability.CONCLUSIONS:
The cumulative effect of self-reported medical comorbidities and type of insurance coverage predict disability above and beyond well-known prognostic variables. Early assessment of medical complications and improving services provided by government-funded insurance may enhance quality of life and reduce long-term health care costs.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Lesões Encefálicas
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Comorbidade
/
Seguro Saúde
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article