The influence of personal factors, unmet need and service obstacles on the relationship between health service use and outcome after brain injury
Abstract Background This exploratory study aimed to: (i) examine the relationship between health service use and quality of life, psychological wellbeing, global function and participation after discharge from brain injury inpatient rehabilitation, and (ii) determine the influence of personal factor...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-022-07811-y |
| _version_ | 1811290458582679552 |
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| author | David N. Borg Jennifer Fleming Joshua J. Bon Michele M. Foster Elizabeth Kendall Timothy Geraghty |
| author_facet | David N. Borg Jennifer Fleming Joshua J. Bon Michele M. Foster Elizabeth Kendall Timothy Geraghty |
| author_sort | David N. Borg |
| collection | DOAJ |
| description | Abstract Background This exploratory study aimed to: (i) examine the relationship between health service use and quality of life, psychological wellbeing, global function and participation after discharge from brain injury inpatient rehabilitation, and (ii) determine the influence of personal factors, unmet need for services and service obstacles on the relationship between service use and these outcomes. Methods Using a prospective cohort design, 41 adults with acquired brain injury (median age = 46 years; 71% male; 61% severe traumatic injury) were followed for 6-months after discharge from specialist brain injury inpatient rehabilitation. Service use was continuously recorded and obtained through data linkage methods, focusing on the use of: outpatient medical services, outpatient nursing, outpatient allied health; medical acute services; incidents of re-hospitalization; and transitional rehabilitation service use. Outcome questionnaire measures were completed via telephone, at 6-months after discharge, and included: the EuroQol-5D; Depression Anxiety and Stress Scale, Mayo-Portland Adaptability Inventory and Sydney Psychosocial Reintegration Scale. Data were analyzed in a heterogeneous treatment effects framework, using Bayesian Additive Regression Trees. Results There was weak evidence that transitional rehabilitation service use was associated with better psychological wellbeing scores. The posterior probability of lower depression, anxiety and stress scores was .87, .81 and .86, respectively (average treatment effect). There was also weak evidence that re-hospitalization was associated with worse independent living skills scores. The posterior probability of worse scores was .87. However, most re-hospitalizations were due to unavoidable medical complications. We did not find that place of residence at discharge, marital status, unmet need, or service obstacles affected the relationship between service use and the studied outcomes. Conclusions This study may highlight the importance of participation in transitional rehabilitation, in the 6-months after discharge from brain injury rehabilitation. Replication in a larger sample size is required to confirm these findings. |
| first_indexed | 2024-04-13T04:13:13Z |
| format | Article |
| id | doaj.art-73de375ee7144aadaadc8711338cf635 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-13T04:13:13Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-73de375ee7144aadaadc8711338cf6352022-12-22T03:03:03ZengBMCBMC Health Services Research1472-69632022-04-0122111110.1186/s12913-022-07811-yThe influence of personal factors, unmet need and service obstacles on the relationship between health service use and outcome after brain injuryDavid N. Borg0Jennifer Fleming1Joshua J. Bon2Michele M. Foster3Elizabeth Kendall4Timothy Geraghty5Griffith University, Menzies Health Institute Queensland, The Hopkins CentreUniversity of Queensland, School of Health and Rehabilitation SciencesGriffith University, Menzies Health Institute Queensland, The Hopkins CentreGriffith University, Menzies Health Institute Queensland, The Hopkins CentreGriffith University, Menzies Health Institute Queensland, The Hopkins CentreGriffith University, Menzies Health Institute Queensland, The Hopkins CentreAbstract Background This exploratory study aimed to: (i) examine the relationship between health service use and quality of life, psychological wellbeing, global function and participation after discharge from brain injury inpatient rehabilitation, and (ii) determine the influence of personal factors, unmet need for services and service obstacles on the relationship between service use and these outcomes. Methods Using a prospective cohort design, 41 adults with acquired brain injury (median age = 46 years; 71% male; 61% severe traumatic injury) were followed for 6-months after discharge from specialist brain injury inpatient rehabilitation. Service use was continuously recorded and obtained through data linkage methods, focusing on the use of: outpatient medical services, outpatient nursing, outpatient allied health; medical acute services; incidents of re-hospitalization; and transitional rehabilitation service use. Outcome questionnaire measures were completed via telephone, at 6-months after discharge, and included: the EuroQol-5D; Depression Anxiety and Stress Scale, Mayo-Portland Adaptability Inventory and Sydney Psychosocial Reintegration Scale. Data were analyzed in a heterogeneous treatment effects framework, using Bayesian Additive Regression Trees. Results There was weak evidence that transitional rehabilitation service use was associated with better psychological wellbeing scores. The posterior probability of lower depression, anxiety and stress scores was .87, .81 and .86, respectively (average treatment effect). There was also weak evidence that re-hospitalization was associated with worse independent living skills scores. The posterior probability of worse scores was .87. However, most re-hospitalizations were due to unavoidable medical complications. We did not find that place of residence at discharge, marital status, unmet need, or service obstacles affected the relationship between service use and the studied outcomes. Conclusions This study may highlight the importance of participation in transitional rehabilitation, in the 6-months after discharge from brain injury rehabilitation. Replication in a larger sample size is required to confirm these findings.https://doi.org/10.1186/s12913-022-07811-yAccessAllied healthRehabilitation |
| spellingShingle | David N. Borg Jennifer Fleming Joshua J. Bon Michele M. Foster Elizabeth Kendall Timothy Geraghty The influence of personal factors, unmet need and service obstacles on the relationship between health service use and outcome after brain injury BMC Health Services Research Access Allied health Rehabilitation |
| title | The influence of personal factors, unmet need and service obstacles on the relationship between health service use and outcome after brain injury |
| title_full | The influence of personal factors, unmet need and service obstacles on the relationship between health service use and outcome after brain injury |
| title_fullStr | The influence of personal factors, unmet need and service obstacles on the relationship between health service use and outcome after brain injury |
| title_full_unstemmed | The influence of personal factors, unmet need and service obstacles on the relationship between health service use and outcome after brain injury |
| title_short | The influence of personal factors, unmet need and service obstacles on the relationship between health service use and outcome after brain injury |
| title_sort | influence of personal factors unmet need and service obstacles on the relationship between health service use and outcome after brain injury |
| topic | Access Allied health Rehabilitation |
| url | https://doi.org/10.1186/s12913-022-07811-y |
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