Hours and costs of formal and informal care following Traumatic Brain Injury and Spinal Cord Injury sustained through Motor Vehicle Accidents: A Cross-sectional Study

Abstract

Objectives: To explore the weekly utilization of formal and informal care, and to calculate and compare the costs associated with these types of care after traumatic brain injury or spinal cord injury sustained through a motor vehicle accident in Australia. Design: Cross-sectional, quantitative design. Subjects: A total of 81 people with traumatic brain injury and 30 people with spinal cord injury from 3 rehabilitation units in New South Wales, Australia. Methods: Data were collected using questionnaires administered through semi-structured interviews, and analysed using a series of Kruskal–Wallis tests. Results: Spinal cord injury (tetraplegia/ paraplegia) was significantly more expensive for both formal and informal care compared with traumatic brain injury. The costs of formal care were significantly greater for those in the traumatic brain injury group who had a more severe injury (post-traumatic amnesia > 90 days) compared with the other traumatic brain injury groups (post-traumatic amnesia 7–28 days, 29–90 days). The costs of informal care were significantly higher for both traumatic brain injury and spinal cord injury compared with the costs of formal care. Conclusion: This study highlights the complementary role of formal and informal care in supporting people with traumatic brain injury or spinal cord injury, particularly highlighting the significant role of informal care, which needs to be more explicitly acknowledged in policy and planning processes. LAY ABSTRACT This study explored the weekly utilization and annual costs of formal (paid support) and informal care (unpaid support) for 81 individuals with traumatic brain injury and 30 with spinal cord injury, sustained in motor vehicle accidents in Australia. Researchers conducted interviews with study participants, who were active clients of 3 separate rehabilitation units in New South Wales (NSW), Australia. Utilization of care differed across and within groups; however, the results showed significantly higher costs for spinal cord injury than for traumatic brain injury. Those with more severe traumatic brain injuries also had significantly higher costs. Finally, informal care was utilized significantly more than formal care services and contributed towards a greater annual “cost”. Overall, these results demonstrate the significant role that informal care has following traumatic brain injury or spinal cord injury. This study highlights the overall importance and value of informal care being recognized more in policy and planning processes.

Keywords

• Traumatic Brain Injury
• Spinal Cord Injury
• Informal care
• Health cost