Characteristics and correlates of rehabilitation charges during inpatient traumatic brain injury rehabilitation in Singapore

KS Chua, A Earnest, Y Chiong, KH Kong
2010 Journal of Rehabilitation Medicine  
Objectives: A prospective study of 91 consecutive traumatic brain injury admissions to rehabilitation over a 2-year period to determine factors impacting on rehabilitation charges. Methods: Discharge records of 91 adult traumatic brain injury patients comprising total unsubsidized billings for each completed inpatient rehabilitation episode were used to derive total charges. Co-variates analysed included demographic, acute traumatic brain injury and rehabilitation variables including the
more » ... ncluding the Modified Barthel Index score. Results: The total median rehabilitation charge per episode was S$7845.50 (range: S$970.55-$44,817.20) [1 Euro = S$2.10]. The top 3 contributory median total charges/episode included bed, board and nursing (S$5616.00), occupational therapy (S$606.00), and physical therapy (S$526.00). Patients with lower admission Glasgow Coma Scale scores, longer post-traumatic amnesia duration, dysphagia and medical complications during rehabilitation, lower admission Modified Barthel Index scores, longer acute and rehabilitation length of stay had significantly higher rehabilitation charges (p < 0.001). Using multiple regression analyses, only rehabilitation length of stay and change in Modified Barthel Index were significantly correlated with total rehabilitation charges (p < 0.001). Discussion: Measures to reduce rehabilitation length of stay, to prevent medical complications, to facilitate transfers to rehabilitation, and expedient discharge planning may help to reduce rehabilitation charges. Conclusion: This study has potential implications for healthcare resource planning for traumatic brain injury rehabilitation.
doi:10.2340/16501977-0476 pmid:20111841 fatcat:fuy7tsdxabajbgakjyvcbtzqyy