| Background: |
It has been reported that individuals with Traumatic Brain Injury (TBI) including those with severe injuries, can work. These findings are primarily based upon outcome of individuals who receive services from State Vocational Rehabilitation agencies. Information on return to work outcomes among individuals who were on workers' compensation is limited. Research is needed to help determine treatment patterns and outcomes for this group. |
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Purpose:
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The study examined the relationship between treatment and outcomes in order to identify tentative hypotheses to guide future research. |
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Study sample: |
A total of 797 files of individuals who were injured between January 1998 and December 2002 in Washington state. |
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Intervention:
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The interventions were medical rehabilitation services, including both inpatient and ambulatory services. |
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Data collection and analysis:
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Data was collected from administrative domains linked to the TBI registry to document outcomes. Data selected from other data domains (ie. payment of non-hospital services, determination of disability and pension benefits and referrals for VR) were linked to the case registry using data processing software. |
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Findings:
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The majority or 70% were between the ages of 20 and 49 years. The majority or 53.5% of the sample had been rated as moderately disabled and 31.1% were permanently disabled. Only 48% included a medical rehabilitation plan. Most were males (N=712). At the end of the study there were 540 closed claims and 257 open, 35 cases had been opened one or more times.
Seventeen percent of the individuals were in coma and 81% required some type of surgical procedure at the time of admission to the hospital. Ninety five individuals received inpatient rehabilitation, 204 had ambulatory rehabilitation and 50 had a combination of the two.
In 72 cases, there was no disability at the end of the study.
There were 426 individuals with temporary disability, who received benefits between 3 to 1588 days, with a median of 19 days. Among 248 individuals with permanent disability, time loss benefits ranged from 5 to 1217 days. The most frequent disability was "the upper arm" occurring in 184 of the cases. There were 157 "mental/neurological disabilities". The vast majority of 92.7% of the permanent disability claims were closed when the study ended. Total accrued disability cost were 34.7 million.
Fifty of the individuals died, 45 noted death as the discharge status of the hospital admission.
At the end of the study 63% were still receiving services, 18% had returned to work, 6% were deemed "employable" and 13% no longer received services due to an inability to rehabilitate. |
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Conclusions:
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Worker's compensation administrative data have detailed information that can be sued to perform studies about treatment patterns and return to work outcomes. Cooperative efforts between State worker's compensation agencies and TBI treatment programs can assist states in providing cost effective treatment post injury. |
