Met and unmet rehabilitative needs among pediatric patients with moderate to severe TBI

ABSTRACT

Objective

Estimate the probability of met and unmet post-acute rehabilitative needs among pediatric patients with moderate to severe traumatic brain injury (TBI).

Participants

One hundred and thirty children who received acute and post-acute rehabilitative services at a hospital for children.

Methods

Prospective, observational study. Recommended service needs (1. Medical, 2. Psychological, 3. Cognitive/Educational, 4. Medically Based Therapies, 5. Community/Caregiver/Family Support) were collected at discharge and 1, 6, 12, and 18 months post-injury. Probabilities were estimated using nonlinear logistic regression models. The impact of age at discharge was also assessed.

Results

Over time, the estimated probability of need for Medical, Medically Based Therapies, and Cognitive/Educational services were consistently high. Whereas unmet need for Medical and Medically Based Therapies were low, unmet need for Cognitive/Educational services were relatively high. Need for Psychological and Community/Caregiver/Family Support services increased in the months post-discharge, as did the probability of unmet need. Older age at discharge was associated with need for Psychological and Community/Caregiver Family Support services.

Conclusions

Findings support the long-term monitoring of need for Psychological and Community/Caregiver/Family Support services among children with moderate to severe TBI. Future research to explore the etiology of unmet needs is warranted.

KEYWORDS:

• Traumatic brain injury
• pediatric rehabilitation
• health services research
• rehabilitation

Acknowledgments

This work does not necessarily represent the views of the Department of Veterans Affairs or the United States Government.

Disclosure statement

Dr. Brenner is consulting for sports leagues. The authors report no additional conflicts of interest.

Additional information

Funding

This study was funded by the Centers for Disease Control and Prevention NCIPC, [R49 CE000394-03] and supported by the VHA Rocky Mountain Mental Illness Research Education and Clinical Center, and the University of Colorado, Anschutz Medical Campus, Department of Physical Medicine and Rehabilitation.