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Which factors determine who is referred for community rehabilitation following traumatic brain injury?
Primary objective: To investigate which variables predict referral for rehabilitation in the participants of the Tasmanian Neurotrauma Register (TNTR), a large (N = 1226) prospective population-based study of adult traumatic brain injury (TBI) in southern Tasmania.
Method: Over a 3-year period, only 54 TBI patients were referred by hospital or local health services for public community rehabilitation, with 121 referred by TNTR research assistants. A further 247 accessed private rehabilitation and 804 received no rehabilitation. These four groups were compared on a range of variables to identify which factors determine referral.
Results: Those referred by hospital or community services and those receiving private rehabilitation had more severe TBI (p <.001), greater disability (p <.001) and were more likely to have been hospitalised post-injury (p <.001). The TNTR-referred group reported more post-concussion symptoms (PCS; p <.001), anxiety (p <.001) and depression (p <.001). TNTR-referral was more likely (p <.001) following assault, compared with other causes of injury. Sixteen per cent of those not referred for rehabilitation had suffered moderate or severe TBI.
Conclusions: These results indicate that no recognised pathway existed for non-hospitalised TBI patients to access public rehabilitation, even if they were reporting high levels of PCS and psychological distress. Furthermore, routine follow-up to assess rehabilitation needs was not occurring in Tasmania, even for some with moderate and severe TBI.
History
Publication title
Brain ImpairmentVolume
14Pagination
222-234ISSN
1443-9646Department/School
School of Psychological SciencesPublisher
Cambridge University PressPlace of publication
United KingdomRights statement
Copyright 2013 Cambridge University PressRepository Status
- Restricted