Abstract:
The U.S. has the highest incidence of penetrating brain injuries of any developed country, with domestic and interpersonal violence the leading cause of these injuries. The mortality rate from gunshot wounds to the brain is now at about 35%, leaving a large population of survivors of violent injuries with potentially devastating, lifelong disabilities. While the direct effects of PBI often result in costly and severe disability, the psychological stress associated with a traumatic event may further complicate and retard functional recovery. Despite the serious consequences, the costs and long-term outcomes of PBI have not been systematically studied. The purpose of our study is to identify the costs and long-term of PBI and to examine the medical, economic, and psychosocial factors that influence PBI recovery. The information will be used to identify strategies to improve the rehabilitation process for these brain injuries survivors. This project will address the study objectives by following up survivors with PBI who have been enrolled in the model systems databases in Georgia, North Carolina, and New Jersey. A comparison group of persons who sustained closed brain injury (CBI) will be identified as well. Controlling for injury severity, the costs and outcomes of PBI and CBI survivors will be compared with respect to physical recovery, cognitive recovery, psychological recovery (Including symptoms of post-traumatic stress), community integration, health-related quality of life, quality adjusted life years (QALY), and costs per QALY. Cost estimated will be based on cost to charge ratios and /or Medicare reimbursement rates that will attached to health care use data. Finally, demographic, socioeconomic, and lifestyle characteristics will be examined to determine their influence on cost and recovery.