Violence related to TBI has enormous impact on the medical system and on society because of the burden of medical, disability and social costs of these injuries. This study will attempt to examine how violence impacts discharge destination following acute medical care. We will compare discharge location and other variables in individuals whose injury was violence related to individuals with non-violence related injuries.
The subjects will be all individuals admitted to the Level I trauma center with a diagnosis of TBI over a 2 year period.
The hypostheses are:
1. Those injured violently are more likely to have focal, severe, and penetrating brain injuries requiring a greater number of neurosurgical interventions. They will be less likely to have severe other-system injuries, but they will be more likely to have a longer length of stay in the acute care setting resulting in higher medical costs.
2. Those injured violently are less likely to have medical insurance than those injured non-violently, and if they do have medical coverage, it will most likely be Medicaid or Medicare.
3 After accounting for the severity of brain and other-system injuries, payer source, and functional level at discharge from acute care, the discharge disposition will be similar for the violently injured and non-violently injured groups.