Perceived health after adult traumatic brain injury: a Group-Based Trajectory Modeling (GBTM) analysis

ABSTRACT

Objective

To provide nationally representative estimates of adults with traumatic brain injury (TBI) and identify clusters of individuals with TBI who follow similar perceived health trajectories using group-based trajectory modeling.

Participants

Adults (≥18 years old) from panels 9–19 (2004–2015) of the Medical Expenditure Panel Survey (MEPS) who experienced a TBI (n = 949).

Design

Data from MEPS, a nationally representative database of noninstitutionalized individuals in the USA, were used to 1) produce a national annual estimate of adults with TBI and 2) identify subgroups of patients with TBI who followed different general and mental health trajectories.

Main Measures

Perceived general health (PGH), perceived mental health (PMH)

Results

On average, 502 adults per 100,000 noninstitutionalized US adults experienced a TBI annually, and about one million adults are living with a TBI. Three distinct trajectory groups were identified in models of both perceived general health (PGH) and perceived mental health (PMH). TBI type, sex, and persistent disability predicted assignment to a group in the PGH model. TBI type, sex, age, insurance status, family poverty status, and persistent disability predicted assignment to a PMH trajectory.

Conclusion

Referrals and early-intervention resources should be distributed to individuals with increased risk of following low PGH and/or PMH trajectories.

KEYWORDS:

• Group-Based Trajectory Modeling (GBTM)
• traumatic brain injury
• disabled persons
• sex differences

Acknowledgments

Thanks to Megan Ramsden for the detailed editing of the manuscript throughout the preparation process.

Disclosure of interest

The authors report no conflict of interest. This project was partially funded by the Health Resources Services Administration (HRSA), through grant #R40MC30759, and Agency for Healthcare Research and Quality (Grant# 1R01 HS24263-01). B. Feldman received funds from the Ohio State University College of Medicine, through the Roessler Medical Student Research Scholarship.

Additional information

Funding

This work was supported by the Agency for Healthcare Research and Quality [1R01 HS24263-01]; Health Resources and Services Administration [R40MC30759].