Post-Acute Care for Traumatic Brain Injury Patients in Taiwan

Abstract

Hsing-Ching Huang,1,* Liu-Ing Bih,1,* Ming-Miau Tsai,1 Tzu-Ling Chang,1 Wan-Chun Liao,1 Chung-Liang Lai2 1Department of Physical Medicine and Rehabilitation, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; 2Department of Occupational Therapy, Asia University, Taichung, Taiwan*These authors contributed equally to this workCorrespondence: Chung-Liang Lai, Department of Occupational Therapy, Asia University, 500, Lioufeng Rd., Wufeng, Taichung 41354, Taiwan, Email [email protected]: Traumatic brain injury (TBI) can result in functional impairments. Many patients with TBI require post-acute care to improve their functional skills and allow for greater self-independence and a better quality of life. Taiwan’s National Health Insurance proposed a nationwide post-acute care program in 2017 for patients with traumatic brain injury. The program’s goal was to maximize patients’ functional recovery and make it possible for them to return to their homes and communities. This study aimed to explore the effectiveness of such programs in Taiwan.Methods: This pilot study retrospectively evaluated a de-identified database that contained the scores of various assessments evaluated at admission and discharge. It used the data to determine the functional improvement of patients with traumatic brain injury after participating in post-acute care programs.Results: This study collected complete data from 27 patients. After an average of 45.11 days in the program, the patients showed significant improvement in the Barthel Activity Daily Living Index, the Lawton–Brody Instrumental Activity Daily Living Scale, the Mini Nutrition Assessment, the EuroQol Five Dimensions Questionnaire, the Berg Balance Scale, the Galveston Orientation and Amnesia Test, the Rancho Los Amigos Scale, the Concise Chinese Aphasia Test, and the Mini Mental State Examination. After discharge, 96% of the patients could return to their community.Conclusion: This pilot study concluded that the program significantly promoted functional recovery for patients and could help patients with traumatic brain injury return to their communities and reduce the risk of institutionalization. Thus, patients with the potential for functional recovery could receive post-acute care in regional or community hospitals immediately after being discharged from acute wards. In the future randomized controlled trials are needed to further confirm the clinical impact of this program.Keywords: traumatic brain injury, rehabilitation, post-acute care

Keywords

• traumatic brain injury
• rehabilitation
• post-acute care