Department of Defense Military Treatment Facility and Community Care Costs After Traumatic Brain Injury in Service Members and Veterans Treated in Veterans Affairs Polytrauma Rehabilitation Centers: A VA TBI Model Systems Study.
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| Title: | Department of Defense Military Treatment Facility and Community Care Costs After Traumatic Brain Injury in Service Members and Veterans Treated in Veterans Affairs Polytrauma Rehabilitation Centers: A VA TBI Model Systems Study. |
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| Authors: | Dismuke-Greer CE; Author Affiliations: Health Economic Resource Center (HERC), VA Palo Alto Care System, Menlo Park, California (Dr Dismuke-Greer); Research Department, Craig Hospital, Englewood, Colorado; Traumatic Brain Injury Model Systems National Data and Statistical Center, Englewood, Colorado (Ms Almeida); Tampa VA Research and Education Foundation at James A. Haley Veterans' Hospital; Department of Emergency Medicine, University of South Florida, Tampa, Florida (Dr Ryan); Chief of Staff Office and TBI Center of Excellence at James A. Haley Veterans Hospital, Department of Internal Medicine, University of South Florida, Tampa, Florida (Dr Nakase-Richardson)., Almeida E, Ryan JL, Nakase-Richardson R |
| Source: | The Journal of head trauma rehabilitation [J Head Trauma Rehabil] 2025 Jul-Aug 01; Vol. 40 (4), pp. E300-E307. Date of Electronic Publication: 2025 Jul 01. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Aspen Publications Country of Publication: United States NLM ID: 8702552 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1550-509X (Electronic) Linking ISSN: 08859701 NLM ISO Abbreviation: J Head Trauma Rehabil Subsets: MEDLINE |
| Imprint Name(s): | Publication: Gaithersburg Md : Aspen Publications Original Publication: [Gaithersburg, Md.] : Aspen, [c1986- |
| MeSH Terms: | Brain Injuries, Traumatic*/economics , Brain Injuries, Traumatic*/rehabilitation , Brain Injuries, Traumatic*/therapy , Brain Injuries, Traumatic*/diagnosis , Veterans* , Military Personnel* , Rehabilitation Centers*/economics , Health Care Costs*/statistics & numerical data , Multiple Trauma*/economics , Multiple Trauma*/rehabilitation , Community Health Services*/economics, Humans ; United States ; Retrospective Studies ; Male ; Female ; Adult ; United States Department of Veterans Affairs/economics ; Middle Aged ; Cost-Benefit Analysis |
| Abstract: | Objective: To estimate cost models of military traumatic brain injury (TBI) that can provide evidence for future cost-effectiveness analyses highlighted as a gap in the recent National Academies of Sciences, Engineering, and Medicine (NASEM) report on accelerating progress in TBI. Setting: Military Treatment Facilities (MTFs) and community care facilities within the Military Health System (MHS). Participants: 1,101 service members/veterans (SMV) diagnosed with a TBI and treated at a Veterans Administration (VA) Polytrauma Rehabilitation Center (PRC). Design: This retrospective study analyzed healthcare costs in MTFs and community care facilities among SMVs diagnosed with TBI and treated at 1 of 5 VA PRCs. MTF and community care records were assessed. Main Measures: Annual MTF and community care inpatient and outpatient costs. TBI disability was measured by the Disability Rating Scale (DRS). Results: Mean age was 31, with 9.8 years of service, and time in MHS post-TBI was 7.18 years. The mean annual inpatient cost was $22,126 in MTFs and $112,218 in community. The mean annual outpatient cost was $17,983 in MTFs and $9,141 in community. Each year of age was associated with $8,276 (95% CI 4,068-12,483), each day of acute care length of stay (LOS) before rehabilitation with $1,024 (95% CI 8-2039), and each additional point on the DRS with $10,858 (95% CI 4,273-17,442) higher costs. Conclusion: Findings describe MHS annualized costs across acute and chronic stages in MTFs and the community and their association with SMVs' TBI disability measured by the DRS. These foundational cost data are critical for informing future hybrid design trials in TBI that examine the economic impact of TBI interventions being studied in future research. (Copyright ©.) |
| References: | Regasa LE, Thomas DM, Gill RS, Marion DW, Ivins BJ. Military deployment may increase the risk for traumatic brain injury following deployment. J Head Trauma Rehabil. 2016;31(1):E28–35. doi:10.1097/HTR.0000000000000155. (PMID: 10.1097/HTR.0000000000000155) DOD TBI worldwide numbers | health.mil. https://health.mil/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence/DOD-TBI-Worldwide-Numbers . Accessed May 26, 2024. Brain Injury Association of America. Centers for medicare and medicaid services officially recognizes brain injury as a chronic condition. https://www.biausa.org/public-affairs/public-awareness/news/centers-for-medicare-and-medicaid-services-officially-recognizes-brain-injury-as-a-chronic-condition#:~:text=%E2%80%93%20In%20a%20victory%20for%20the%20brain%20injury,program%20effective%20for%20the%20January%202025%20plan%20year . Accessed July 31, 2024. Armstrong M, Champagne J, Mortimer DS. 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| Contributed Indexing: | Keywords: healthcare costs; military health system; traumatic brain injury |
| Entry Date(s): | Date Created: 20250121 Date Completed: 20250708 Latest Revision: 20250708 |
| Update Code: | 20250708 |
| DOI: | 10.1097/HTR.0000000000001028 |
| PMID: | 39837340 |
| Database: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstract: | Objective: To estimate cost models of military traumatic brain injury (TBI) that can provide evidence for future cost-effectiveness analyses highlighted as a gap in the recent National Academies of Sciences, Engineering, and Medicine (NASEM) report on accelerating progress in TBI.<br />Setting: Military Treatment Facilities (MTFs) and community care facilities within the Military Health System (MHS).<br />Participants: 1,101 service members/veterans (SMV) diagnosed with a TBI and treated at a Veterans Administration (VA) Polytrauma Rehabilitation Center (PRC).<br />Design: This retrospective study analyzed healthcare costs in MTFs and community care facilities among SMVs diagnosed with TBI and treated at 1 of 5 VA PRCs. MTF and community care records were assessed.<br />Main Measures: Annual MTF and community care inpatient and outpatient costs. TBI disability was measured by the Disability Rating Scale (DRS).<br />Results: Mean age was 31, with 9.8 years of service, and time in MHS post-TBI was 7.18 years. The mean annual inpatient cost was $22,126 in MTFs and $112,218 in community. The mean annual outpatient cost was $17,983 in MTFs and $9,141 in community. Each year of age was associated with $8,276 (95% CI 4,068-12,483), each day of acute care length of stay (LOS) before rehabilitation with $1,024 (95% CI 8-2039), and each additional point on the DRS with $10,858 (95% CI 4,273-17,442) higher costs.<br />Conclusion: Findings describe MHS annualized costs across acute and chronic stages in MTFs and the community and their association with SMVs' TBI disability measured by the DRS. These foundational cost data are critical for informing future hybrid design trials in TBI that examine the economic impact of TBI interventions being studied in future research.<br /> (Copyright ©.) |
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| ISSN: | 1550-509X |
| DOI: | 10.1097/HTR.0000000000001028 |