The Correlation Between Outcomes & Cost of Acquired Brain Injury Rehabilitation

According to scientifically validated research, post-acute brain injury rehabilitation, one of the specialized services we offer at our brain injury facility – NeuLife Rehab, improves the quality of life of individuals who have experienced an acquired brain injury (ABI) and reduces lifetime medical costs.

The Centers for Disease Control and Prevention (CDC) reported that ABI is a major cause of death and disability in the United States. ABIs contribute to about 30.5% of all injury-related deaths1. Those who survive an ABI can face short term effects or long-term effects that could last the rest of their lives. In the United States, approximately 5.3 million people have ABI-related disabilities that include long lasting cognitive and psychological impairments.2 The effects of ABI can include impaired thinking, attention or memory, movement, balance, sensation (e.g., vision or hearing), or emotional functioning (e.g., personality changes, depression). These issues not only affect brain injury survivors and their ability to work, perform household tasks, drive and engage in other activities of daily living but have profound effects on families and communities. Permanent ABI-related disability can also result in enormous financial burden including significant medical costs.

Rehabilitation is the predominant post-acute treatment for individuals with ABI.3 Scientific research confirms that a post-acute rehabilitation program with a multidisciplinary approach such as the program we provide at our brain injury facility – NeuLife Rehab , is more likely to be effective in the treatment of ABI patients. NeuLife’s multidisciplinary program includes, but is not limited to physiatry medical management, nursing services, psychiatry, internal medicine, physical, occupational, speech, recreational and neuropsychological/neurobehavioral therapies, community re-integration and vocational evaluation.

In an article published in the May 2015 issue of Journal of Neurotrauma called “Post-Acute Acquired Brain Injury Rehabilitation: Effects on Outcome Measures and Life Care Costs” written by Grace S. Griesbach, Lisa A. Kreber, David Harrington and Mark J. Ashley, the authors scientifically evaluated and measured both the functional effectiveness and cost effectiveness of post-acute ABI rehabilitation by comparing outcome measures and life care costs with that of patients with cerebrovascular accident (CVA) who underwent a similar multidisciplinary rehabilitation program4. In this retrospective study of 36 former ABI and CVA rehab patients, functional effectiveness was determined through an assessment of the patient’s level of functional independence at least one (1) year post discharge, using outcome scales that evaluate level of disability as well as social, cognitive, emotional and physical problems. Cost effectiveness was determined by completion of life care plans, or lifetime cost projections by independent certified life care planners for each of the 36 patients, both prior to, and after, post-acute rehabilitation, i.e., with and without post-acute rehabilitation. Of note, the majority of the patients in the study completed a residential post-acute rehabilitation program for 5 days per week for variable lengths of stay; however, the median duration of treatment was 197 days of rehabilitation.

The data conclusively revealed that post-acute rehabilitation, with or without traditional acute rehabilitation, significantly improved functional outcomes for all 36 patients. These patients demonstrated improved quality of life, higher levels of function and independence, decreased disability and level of assistance needed for daily living, reduction in ABI-related morbidity and increases in occupational status or ability to return to work or vocation. The team of clinical experts at NeuLife proudly stands behind its quality clinical outcomes including, but not limited to its functional, cognitive and behavioral outcomes.

In addition to improved functional outcomes and quality of life, the study concluded that ABI-related lifetime cost projections markedly diminished after post-acute rehabilitation, referred to throughout the study as “rehabilitation savings” (RS).5 In other words, those patients who underwent post-acute ABI rehabilitation were projected to incur lower life care costs compared to patients who did not continue rehabilitation during the post-acute period. More specifically, the costs needed for long term needs such as hospitalizations, medical procedures, nursing, attendant care, medications and the like over the patient’s life expectancy significantly decreased after post-acute ABI rehabilitation. In fact, the study showed that on average, over $2 million was saved in lifetime costs per patient for those who received post-acute care. Cost and functional effectiveness was more pronounced when post-acute rehabilitation was initiated within the 1st year after ABI.

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About NeuLife Rehabilitation
NeuLife Rehabilitation is one of the largest residential post-acute rehabilitation programs of its kind specializing in catastrophic rehabilitation for Acquired Brain Injury (ABI), Spinal Cord Injury (SCI) and other complex injuries. Individuals who have experienced a catastrophic or complex work injury or illness such as an acquired brain or spinal cord injury, amputation, severe burn, complex orthopedic injury, stroke or other debilitating condition can now access quality specialized rehabilitation in a therapeutic, residential environment that offers individualized care and programming that will help them achieve the highest level of functional independence and the best quality of life.

NeuLife’s mission is to provide a comprehensive outcomes-based program of neuro rehab to support and promote the improvement of the quality of life of our patients. Based on our most recent data, our patients achieve an average functional improvement of 80% from admission to discharge. Our average length of stay varies depending on patient need. In addition, 86% of our patients are discharged to home, work or school and successfully reintegrated into the community, resulting in substantial rehabilitation savings for our patients with ABI, their families and other stakeholders.

NeuLife is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF). Programs include inpatient general and neurological rehabilitation, behavioral/cognitive therapy, community reintegration and Supported Living.

For additional information about NeuLife, please visit our website or call us at 1-800-626-3876. Please also feel free to contact our Clinical Liaisons, Wendy McCracken at 904-534-2518, Brandy Narciso at 813-892-5471 or Fred Langan at 727-308-8073 to discuss a possible referral.

FootnoteFootnote Description
1Taylor CA, Bell JM, Breiding MJ, Xu L. Acquired Brain Injury–Related Emergency Department Visits, Hospitalizations, and Deaths — United States, 2007 and 2013. MMWR Surveill Summ 2017;66(No. SS-9):1–16. DOI: http://dx.doi.org/10.15585/mmwr.ss6609a1.
2Selassie, A.W., Zaloshnja, E.P., Langlois, J.A., Miller, T., Jones, P., and Steiner, C. Incidence of long-term disability following Acquired brain injury hospitalization, United States, 2003. (2008). J. Head Trauma Rehabil. 23, 123–131. Dams-O’Connor, K., Spielman, L., Singh, A., Gordon, W.A., Lingsma, H.F., Maas, A.I., Manley, G.T., Mukherjee, P., Okonkwo, D.O., Puccio, A.M., Schnyer, D.M., Valadka, A.B., Yue, J.K., Yuh, E.L., and TRACK-ABI Investigators. (2013). The impact of previous Acquired brain injury on health and functioning: a TRACK-ABI study. J. Neurotrauma 30, 2014–2020. Turner-Stokes, L. (2008). Evidence for the effectiveness of multidisciplinary rehabilitation following acquired brain injury: a synthesis of two systematic approaches. J. Rehabil. Med. 40, 691–701.
3Mary Ann Liebert, Inc., Journal of Neurotrauma 32:704-711 (May 15, 2015).
4Mary Ann Liebert, Inc., Journal of Neurotrauma 32:704-711 (May 15, 2015).
5Mary Ann Liebert, Inc., Journal of Neurotrauma 32:704-711 (May 15, 2015).