HEAD-INJURY REHABILITATION IN THE UK - AN ECONOMIC-PERSPECTIVE

The human and societal costs as a result of traumatic brain injury (TB I) are extensive with approximately 200-300/100000 of the population r equiring hospitalisation each year in the U.K. Advances in neurosurgic al management have meant that more people sustaining head injuries are surviving. The need for rehabilitation programmes for these individua ls is therefore ever increasing. While in the U.S.A. rehabilitation pr ogrammes for TBI patients are well established, in the U.K. the provis ion of such services is patchy and varies widely in different localiti es. The belated response to the rehabilitation needs of this group of individuals in the U.K., has coincided with an increased awareness of the economic efficiency of health care provision. This paper criticall y reviews published studies looking at the economics of rehabilitation services for brain injured patients. No studies in the U.K. were iden tified and all the sources discussed are from the U.S.A. The methodolo gical guidelines underlying economic appraisal of health care are summ arised and the studies assessed to determine the extent to which they fulfil these guidelines. The paper concludes that most studies purport ing to provide evidence of cost-effectiveness did not include appropri ate data, nor followed the methodological guidelines allowing such cla ims to be made. Some recommendations for future research are presented . (C) 1997 Elsevier Science Ltd.