Karen Sui-Geok Chua, Arul Earnest, Yii Chiong , Keng-He Kong
DOI: 10.2340/16501977-0476

Objectives: A prospective study of 91 consecutive traumatic brain injury admissions to rehabilitation over a 2-year period to determine factors impacting on rehabilitation charges.
Methods: Discharge records of 91 adult traumatic brain injury patients comprising total unsubsidized billings for each completed inpatient rehabilitation episode were used to derive total charges. Co-variates analysed included demographic, acute traumatic brain injury and rehabilitation variables including the Modified Barthel Index score.
Results: The total median rehabilitation charge per episode was S$7845. 50 (range: S$970. 55–$44,817. 20) [1 Euro = 
S$2. 10]. The top 3 contributory median total charges/episode included bed, board and nursing (S$5616. 00), occupational therapy (S$606. 00), and physical therapy (S$526. 00). Patients with lower admission Glasgow Coma Scale scores, longer post-traumatic amnesia duration, dysphagia and medical complications during rehabilitation, lower admission Modified Barthel Index scores, longer acute and rehabilitation length of stay had significantly higher rehabilitation charges (p < 0. 001). Using multiple regression analyses, only rehabilitation length of stay and change in Modified Barthel Index were significantly correlated with total rehabilitation charges (p < 0. 001).
Discussion: Measures to reduce rehabilitation length of stay, to prevent medical complications, to facilitate transfers to rehabilitation, and expedient discharge planning may help to reduce rehabilitation charges.
Conclusion: This study has potential implications for healthcare resource planning for traumatic brain injury rehabilitation.