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How well does the TBIMS-NDB represent the population of all persons 16 years and older in the United States receiving acute, in-patient rehabilitation for TBI?

Categories: Outcomes

The Question

The Traumatic Brain Injury Model Systems National Database (TBIMS-NDB) contains information about hospital stays and outcomes for over 10,000 people treated for TBI in participating centers since 1988. How well does the TBIMS-NDB represent the population of all persons 16 years and older in the United States receiving acute, in-patient rehabilitation for TBI?

Past studies

Past studies: Since many researchers use the information contained in the Traumatic Brain Injury Model Systems National Database to learn about acute rehabilitation and long-term outcomes after TBI, some preliminary research was conducted to describe how well findings can be generalized to all persons 16 years and older in the United States receiving hospital rehabilitation for TBI. Some possible differences that might influence the representativeness of the sample were identified, including age, race, and longer acute hospital length of stay. 

This study

This study: A more direct evaluation was made possible when a public policy related to reimbursement was changed in 2001. As a result, comprehensive national data began to be collected for all persons in the US receiving inpatient rehabilitation. In this study, a dataset was created from the US TBI rehabilitation population data and compared to the TBIMS-NDB. It was hypothesized that the characteristics of all persons 16 years and older in the US receiving hospital rehabilitation would be similar to the characteristics of those in the TBIMS-NDB.

Variables with important differences included age (the TBIMS-NDB patients tended to be younger), rehabilitation length of stay (fewer patients with shortest stays for TBIMS-NDB), marital status (more never married patients in the TBIMS-NDB), and primary payment source (fewer patients with Medicare and more with Medicaid and private insurance in the TBIMS-NDB). The largest difference was in age of the cohorts. When the cases were grouped by age (<65 years old and 65+ years old), other differences related to age, such as having Medicare as a payer, were less marked.

Bottom line
 
There is strong evidence that the Traumatic Brain Injury Model Systems National Database (TBIMS-NDB) can be used with confidence to answer research questions about all patients receiving inpatient rehabilitation for TBI in the United States. Researchers using the TBIMS-NDB could more closely represent the US TBI rehabilitation population by weighting for age.

 

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Find This Study

Representativeness of the Traumatic Brain Injury Model Systems National Database

Corrigan, John D.; Cuthbert, Jeffrey P.; Whiteneck, Gale G.; Dijkers, Marcel P.; Coronado, Victor; Heinemann, Allen W.; Harrison-Felix, Cynthia; Graham, James E.Journal of Head Trauma Rehabilitation. 27(6):391-403, November/December 2012 Keywords: Model Systems, database, TBIMS-NDB

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