Traumatic Brain Injury Linked to Increased Health Care Usage

Patients with traumatic brain injury (TBI) have higher health care utilization and health needs across health care settings, according to research published in The Journal of Head Trauma Rehabilitation.

Researchers analyzed data from the 2018 and 2019 MarketScan Commercial Claims and Encounters database to assess differences in longitudinal health outcomes among patients with and without TBI in the year following an index health encounter.

A matched retrospective cohort design was used to identify individuals with vs without TBI in 2018; participants were matched 1:1. Individuals without TBI in 2018 were assigned a random index date that matched an index date for an individual with TBI. Outcomes included new diagnoses among children and adults, and measures of health care utilization stratified by TBI status. T-test and Cohen’s d were employed for statistical analysis.

Each cohort included 72,338 patients. The study population was composed primarily of children (47.8%) and young adults aged between 18 and 24 years (18.9%). Men accounted for 50.6% of the population, and 37.8% of participants resided in the Southern United States.

Within 1 year of the index date, 70.7% of children with TBI received a new diagnosis, compared with 48.9% of children without TBI. Similarly, 83.9% of adults with TBI received a new diagnosis, compared with 60.2% of adults without TBI. Among those with TBI, the most common new diagnoses were headache (19.1%) and cough (16.1%) in children, and hypertension (22.4%) and headache (18.2%) in adults.

Patients with TBI were also more likely to utilize health care services. Specifically, 96.7% of patients had at least 1 outpatient visit within 1 year of the index date, compared with 86.1% of those without TBI (P <.0001). Emergency department visits were also more frequent among those with TBI than those without (28.5% vs 13.1%; P <.0001).

After adjusting for age, sex, urbanicity, and insurance type, patients with TBI remained significantly more likely to have outpatient visits, emergency department visits, and hospital admissions (all P <.0001).

Study limitations include a lack of uninsured participants and the use of diagnostic codes.

“These findings indicate that people who sustain a TBI may have greater health care needs,” the authors concluded.