Identification of hidden health utilization services and costs in adults awaiting tertiary care following mild traumatic brain injury in Toronto, Ontario, Canada
Cindy Hunt,
Katrina Zanetti,
Brian Kirkham,
Alicja Michalak,
Cheryl Masanic,
Chantal Vaidyanath,
Shree Bhalerao,
Michael D Cusimano,
Andrew Baker,
Donna Ouchterlony
Affiliations
Cindy Hunt
1Head Injury Clinic, St. Michael's Hospital, Toronto, ON, Canada
Katrina Zanetti
1Head Injury Clinic, St. Michael's Hospital, Toronto, ON, Canada
Brian Kirkham
1Head Injury Clinic, St. Michael's Hospital, Toronto, ON, Canada
Alicja Michalak
1Head Injury Clinic, St. Michael's Hospital, Toronto, ON, Canada
Cheryl Masanic
1Head Injury Clinic, St. Michael's Hospital, Toronto, ON, Canada
Chantal Vaidyanath
1Head Injury Clinic, St. Michael's Hospital, Toronto, ON, Canada
Shree Bhalerao
1Head Injury Clinic, St. Michael's Hospital, Toronto, ON, Canada
Michael D Cusimano
4St. Michael's Hospital, Toronto, ON, Canada
Andrew Baker
6Department of Critical Care, St. Michael's Hospital, Toronto, ON, Canada
Donna Ouchterlony
1Head Injury Clinic, St. Michael's Hospital, Toronto, ON, Canada
Aim: The cognitive, emotional, behavioral and physical impairments experienced by adults after mild traumatic brain injury (mTBI) can produce substantial disability, with 15–20% requiring referral to tertiary care (TC) for persistent symptoms. Methods: A convenience sample of 201 adult patients referred to TC as a result of mTBI was studied. Self-reported data were collected at first TC visit, on average 10 months postinjury. Patients reported the type and intensity of healthcare provider visit(s) undertaken while awaiting TC. Results: On average males reported 37 and females 30 healthcare provider visits, resulting in over $500,000 Canadian dollars spent on potentially excess mTBI care over 1 year. Discussion: Based on conservative estimate of 15% of mTBI patients receiving TC, this finding identifies a possible excess in care of $110 million for Ontario. Accurate diagnosis of mTBI and early coordination of follow-up care for those needing TC could increase cost–effectiveness.
