Health care utilization after hospitalization following a road traffic accident

Abstract

Purpose: In recent years, there has been an increasing interest in measuring and modeling health care utilization. However, only limited research has been performed in the field of health care utilization following road traffic accidents. This article aims to measure the incremental health care utilization after hospital discharge after a road traffic accident and explore the association between socio-demographic and injury-related variables and health care utilization.

Material and methods: Generalized linear models with negative binomial distribution and log-link were executed per type of health care provider (general practitioner, medical specialists, rehabilitation services and outpatient nursing care) and per type of discharge location (discharged to home, discharged to in-hospital rehabilitation). Health care utilization of the 6 months after discharge was compared with the 6 months before the accident (baseline care).

Results: Health care utilization six months after discharge is significantly higher than baseline care, except for outpatient nursing care and general practitioners in in-hospital rehabilitation. The increase in visits to medical specialists ranged on average between 1 and 2.2 visits. For general practitioner, there was an increase of 0.4 visits and 0.8 in outpatient nursing care for those who returned home after acute hospitalization. The average increase in rehabilitation services ranged between 3.6 and 20. Associated influential factors differ per health care provider and discharge destination.

Conclusion: Evidence of this study suggests higher health care utilization during the first 6 months following hospitalization due to a road traffic injury, compared with baseline care. Associated variables differ per type of health care provider and discharge-destination. More in-depth research on subgroups is needed.

Implications for rehabilitation

• Health care utilization varies across different patient characteristics and type of injuries which should be considered in the communication with patients on their care trajectory post-discharge.

• General descriptions of health care utilization in traffic victims at the population level are lacking. Output similar to our study could serve as a reference for post-discharge care planning.

• The research output can be a starting point for future research on quality indicators of the expected quantity of care.

• Efforts must be made to estimate suchlike reference tables on post-discharge services in other patient groups and secondary data are a suitable data-source for those analyses.

Keywords:

• Health care utilization
• road traffic injury
• rehabilitation
• secondary data
• Andersen’s behavioral model

Ackowledgements

This study is part of the REKOVER project, which is focused on the registration and societal costs of traffic accidents and is carried out at I-CHER in cooperation with the Belgian Road Safety Institute (BRSI). We would like to thank FPS Health (Ingrid Mertens, Eveline Depuijdt, Nathalie Terryn), the Department Data Management and the Technical Cell of the National Institute for Health and Disability Insurance (Yves Parmentier), and Intermutualistic Agency (Ragna Préal and Birgit Gielen) for their cooperation and support in the data extraction, data storage, and data security. Furter we would like to thank the people from the stearing comitée Prof Nicole Pouliart, Carlotte Kiekens, Wouter Van den Berghe and Joke Schepers. We would like to thank Elisabeth Versailles from SAS Belgium for providing and assisting us with the SAS-software.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by Agency for Innovation by Science and Technology in Flanders, [SBO mandate].