The following is a summary of “Association Between Racial Marginalization with Direct Healthcare Expenditure, Time at Home and Rehabilitation Access Following Moderate to Severe Traumatic Brain Injury,” published in the November 2024 issue of Surgery by Malhotra et al.
The ethno-racial background has been linked to health disparities in traumatic brain injury (TBI) outcomes, though the study in universal healthcare settings remains limited.
Researchers conducted a retrospective study to examine the association between racialized neighborhood residence and direct healthcare costs, days at home (DAH), and rehabilitation access following moderate to severe TBI.
They used linked administrative health data (2009 to 2021) to identify adults with moderate to severe TBI. The primary exposure was a neighborhood-level index indicating the degree of racialized and immigrant populations (Q1–least racialized to Q5–most racialized). Primary outcomes included direct healthcare costs and DAH365 days after injury. Secondary outcomes were discharged to rehabilitation, and functional independence measure (FIM) scores at rehabilitation discharge.
The results showed patients from the most racialized neighborhoods incurred higher crude and adjusted direct healthcare costs compared to those from the least racialized neighborhoods, mainly driven by physician claims and acute care costs. No significant differences in crude or adjusted DAH across the quintiles. Access to rehabilitation and discharge FIM scores were comparable across different racialized neighborhood quintiles.
They concluded that despite differences in healthcare expenditures, no significant differences in DAH, rehabilitation access, or discharge FIM scores based on racialized neighborhood residence.
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