Factors that influence costs and length of stay of persons with traumatic brain injury in acute care and inpatient rehabilitation

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Abstract
This study investigated factors that influence the costs (hospital charges) and length of stay (LOS) in acute care and in rehabilitation of 301 persons with traumatic brain injury (TBI). Factors examined included initial severity of brain injury, external cause of injury, blood alcohol level, intracranial operations, and designated payor. As expected, more severely injured persons had longer LOS and higher charges for both acute care and rehabilitation. Overall mean LOS in acute care was 27 days (standard deviation [SD] = 24) and charges (not including physicians' fees) were $66,368. Overall mean LOS in rehabilitation was 48 days (SD = 47) and charges were $51,416. The external causes of injury resulting in the largest average overall charges (acute care and rehabilitation combined) were motorcycle accidents ($165,294 per case) and gunshot wounds to the head ($164,250 per case). Ninety-five percent of persons included in the study were living in private residences just prior to the onset of their injuries, and 81% were discharged from inpatient rehabilitation to a private residence. No trends were evident regarding the LOS and type of designated payor for rehabilitation services. The results support the premise that the TBI model systems are effective in minimizing the average LOS and in achieving functional benefits that reduce the disability of persons with severe TBI.

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