Charges and lengths of stay for acute and inpatient rehabilitation treatment of traumatic brain injury 1990-1996

This investigation evaluated yearly trends in charges and lengths of stay f or patients with brain injury in acute care and rehabilitation settings ove r a 7 year period. Data was collected from 800 consecutive patients enrolle d in four NIDRR Model Systems Traumatic Brain Injury programmes. Acute care daily charges showed almost routine increases, averaging nearly $550 per y ear. Conversely, lengths of stay generally showed a downward trend, with an nual reductions averaging 2.25 days. Admission lengths of stay averaged 22- 29 days between 1990-1994. Admissions averaged less than 20 days beginning in 1995, with the 1996 average of 16 days, nearly half that of the 1993 ave rage. Between 1990-1996, average daily rehabilitation charges increased eac h year, with the rise averaging $83 or 7%. The rise in daily rehabilitation charges was offset by corresponding decreases in lengths of stay averaging 3.65 days or 8% annually. Increases in daily charges for brain injury reha bilitation care were roughly comparable to those for general medical care p rices. However, the rate of change in acute care charges was substantially greater, with annual increases averaging 10% more than national medical car e prices. The steady downward trend in lengths of stay raises serious conce rns about the future availability of health care services to persons with b rain injury.