Considerations for developing chronic care system for traumatic brain injury based on comparisons of cancer survivorship and diabetes management care

Abstract

Experts in traumatic brain injury (TBI) rehabilitation recently proposed the framing of TBI as a chronic disease rather than a discrete event. Within the framework of the Chronic Care Model (CCM), a systematic comparison of three diseases – cancer survivorship, diabetes management and TBI chronic care – was conducted regarding chronic needs and the management of those needs. In addition, comparisons of these conditions require comparative evaluations of disease management characteristics and the survivor concept. The analysis found diabetes is more established within the CCM, where care is integrated across specialists and primary care providers. No single comparison provides a full analogue for understanding the chronic care health delivery system for TBI, indicating the need for a separate model to address needs and resources for TBI survivors. The findings from this research can provide practitioners with a context to develop a robust continued care health system for TBI.

Practitioner Summary: We examine development of a chronic care system for traumatic brain injury. We conducted a systematic comparison of Chronic Care Model elements of decision and information support. Development of capabilities using a benchmark of diabetes care, with additional insights from cancer care, provides insights for implementing TBI chronic care systems.

Keywords:

• Health care systems engineering
• traumatic brain injury
• Chronic Care Model
• chronic care
• disease management

Acknowledgements

The authors thank the Purdue Graduate School and the School of Industrial Engineering for their support of this work through the Purdue Doctoral Fellowship.