Discharge destination from acute care after traumatic brain injury

OBJECTIVE: To identify the impact of private insurance coverage on discharge disposition after a traumatic brain injury (TBI) using injury in a motor vehicle accident (MVA) as a proxy for private insurance, controlling for age and severity of injury. METHOD: Cross-sectional study. PATIENTS: Patients with TBI discharged between 1993-1994 and 2000-2001 (n = 9,703). MAIN OUTCOME MEASURE: Discharge destination from acute care; controlled odds ratio (OR) and confidence interval (CI) for type of injury. RESULTS: Type of injury, age, and length of stay are significantly associated with discharge destination. However, the motor vehicle accident patients are 56% more likely to be discharged to home with support services than patients with similar injuries from falls. CONCLUSION: Even in a system with universal coverage, availability of private insurance type is a potential independent determinant of post-acute care services. More research is required to determine the effect this relationship has on the cost and outcomes of care for TBI patients.