Predictors of behavioural health service use and associated expenditures: Individuals with TBI in Pinellas County

Abstract

Objective: Traumatic brain injury (TBI) is a major public health concern. Such injuries often result in dramatic changes in the individual’s life-course due to the associated complex co-morbidities. Limited research exists on the use and expenditures incurred for behavioural healthcare services post-TBI. This study examined predictors of behavioural service use, incarceration and associated expenditures for individuals with TBI.

Methods: Emergency Medical Services and Medicaid Claims data were used to identify individuals diagnosed with a TBI in Pinellas County, Florida, in FY 2005. Ten statewide and local administrative data sets from 2005–2008 were employed to determine subject’s demographic characteristics, criminal justice encounters, behavioural health services use and associated expenditures. Average annual expenditures and use of mental health, substance abuse and criminal justice services over a 3-year period were determined.

Results: A total of 1005 individuals diagnosed with TBI were identified and, of these, 910 survived the 3-year period. Study participants were grouped into high and low behavioural health expenditure groups. Those in the high expenditure group were more likely to be male, white and to have received behavioural health services.

Conclusions: This study provides new information about predictors of behavioural health service use and Medicaid expenditures for Floridians with TBI.

• Cost
• incarceration
• mental health
• service access
• traumatic brain injury

Acknowledgements

The authors would like to thank Charles Dion, MA and the staff at the Policy and Services Research Data Center (PSRDC) in the Department of Mental Health Law & Policy, Louis de la Parte Florida Mental Health Institute, University of South Florida.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.