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Study: Big Variation in Outcomes Among TBI Rehabilitation Centers

When researchers at Baylor University began their recent study, their goal was to identify which techniques used to help rehabilitate people with traumatic brain injuries were most effective. They set out to analyze the outcomes for patients at 21 rehabilitation centers using the Traumatic Brain Injury Model System, or TBIMS, measuring the patents’ progress at the time of discharge and a year later.

They expected to find that successful rehabilitation for those with traumatic brain injuries would depend in large part upon the patient characteristics and injury severity, but comparing outcomes among similar patients treated with different therapeutic techniques would reveal the most effective practices.

What the researchers didn’t expect was for substantial variations in the outcomes for similar patients receiving the same treatment but at different rehabilitation centers. Unfortunately, the outcomes at some centers averaged between 25- to 45-percent better than at others.

Public health researchers have long known of large variations in patient outcomes among providers in other medical specialties, including trauma centers, transplant surgery centers and oncology providers. This study, which was published in the Journal of Head Trauma Rehabilitation, is the first to demonstrate differences among rehabilitation providers.

As you might expect, the researchers provisionally attributed the differences to variations in available resources, institutional structures, and other factors known to affect patient outcomes in other healthcare settings. As for precisely which factors were most important, additional research will unfortunately be needed.

As for what treatments are most effective, the researchers are still poring over data. They’re currently cross-referencing patient and injury characteristics with the type of therapy they received and their ultimate functional outcomes. Hopefully, those factors will lead to new, evidence-based best practices in inpatient rehabilitation therapies for traumatic brain injury victims.

The team’s discovery that some traumatic brain injury rehabilitation centers produce far better results than others has already sparked discussion within the research community, said one of the study’s authors. While the ultimate goal of the research is to produce evidence-based best practices for physical, occupational, neurocognitive and other interventions for traumatic brain injury patients, it may be just as important to improve the performance of centers with poorer-than-average outcomes.

A traumatic brain injury can be life-altering. Victims can suffer dramatic changes in everything from personality and mood to motor skills and cognition. Hopefully, this information leads to improved treatment for all those in the rehabilitation process.

Source: Claims Journal, “Baylor Researchers Study Traumatic Brain Injury Rehab Outcomes,” Dec. 9, 2013