Abstract:
Examine billing patterns and predictors of health care utilization and costs associated with traumatic brain injury (TBI).

Design: Retrospective cohort study of health care billings.

Participants: 63 persons with TBI were followed over a 19-month period, in state-sponsored Medicaid pogram.

Main Outcome Measures: The relationship of indicators of injury severity and disability to such billings was investigated.

Results: Mean age at time of injury was 33 years. Mean highest Glasgow Coma Scale (GCS) rating immediately post brain injury was 8. A total of $795,635 was billed to Medicaid for 3,950 services and medications used. Motor deficits at discharge from inpatient rehabilitation (FIM Motor Score) showed inverse relationships to total billings (rho = -.42, p < .001), and subcategories of billings reflecting equipment and supplies (rho = -.26, p = .020), and outpatient billings (rho = -.27, p = .015). Change in FIM Motor scores during inpatient rehabilitation was inversely associated with billings (rho = -.40). Change in FIM motor scores provided unique information in predicting utilization, after accounting for demographic characteristics and severity of injury. Conclusions: Motor disability and improvement during inpatient rehabilitation were significant predictors of billings post-TBI. Initial severity of brain injury was not a significant factor in utilization.