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Which Factors Determine Who is Referred for Community Rehabilitation Following Traumatic Brain Injury?

Published online by Cambridge University Press:  22 August 2013

Gillian Ta'eed*
School of Psychology, University of Tasmania, Australia
Clive E. Skilbeck
School of Psychology, University of Tasmania, Australia Tasmanian Neurotrauma Register, Royal Hobart Hospital, Tasmania, Australia
Mark Slatyer
School of Psychology, University of Tasmania, Australia Tasmanian Neurotrauma Register, Royal Hobart Hospital, Tasmania, Australia
Address for correspondence: Gillian Ta'eed, School of Psychology, University of Tasmania, Australia. E-mail:
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Primary objective: To investigate which variables predict referral for rehabilitation in the participants of the Tasmanian Neurotrauma Register (TNTR), a large (N = 1226) prospective population-based study of adult traumatic brain injury (TBI) in southern Tasmania.

Method: Over a 3-year period, only 54 TBI patients were referred by hospital or local health services for public community rehabilitation, with 121 referred by TNTR research assistants. A further 247 accessed private rehabilitation and 804 received no rehabilitation. These four groups were compared on a range of variables to identify which factors determine referral.

Results: Those referred by hospital or community services and those receiving private rehabilitation had more severe TBI (p < .001), greater disability (p < .001) and were more likely to have been hospitalised post-injury (p < .001). The TNTR-referred group reported more post-concussion symptoms (PCS; p < .001), anxiety (p < .001) and depression (p < .001). TNTR-referral was more likely (p < .001) following assault, compared with other causes of injury. Sixteen per cent of those not referred for rehabilitation had suffered moderate or severe TBI.

Conclusions: These results indicate that no recognised pathway existed for non-hospitalised TBI patients to access public rehabilitation, even if they were reporting high levels of PCS and psychological distress. Furthermore, routine follow-up to assess rehabilitation needs was not occurring in Tasmania, even for some with moderate and severe TBI.

Copyright © The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 2013 

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