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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*
Affiliation:
School of Psychology, University of Tasmania, Australia
Clive E. Skilbeck
Affiliation:
School of Psychology, University of Tasmania, Australia Tasmanian Neurotrauma Register, Royal Hobart Hospital, Tasmania, Australia
Mark Slatyer
Affiliation:
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: gillian.taeed@utas.edu.au
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Abstract

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.

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

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