Characteristics and Treatment Patterns of Service Members with Mild Traumatic Brain Injury
Apr 18, 2016
A RAND study, the first to examine care received by a census of active-duty service members diagnosed with mild traumatic brain injury in the Military Health System, assessed the number and characteristics of these patients (including deployment history and history of traumatic brain injury), their care settings, the treatments they received, co-occurring conditions, the duration of treatment, and the risk factors for requiring long-term care.
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Traumatic brain injury (TBI) is considered a signature injury of modern warfare, though TBIs can also result from training accidents, falls, sports, and motor vehicle accidents. Among service members diagnosed with a TBI, the majority of cases are mild TBIs (mTBIs), also known as concussions. Many of these service members receive care through the Military Health System, but the amount, type, and quality of care they receive has been largely unknown. A RAND study, the first to examine the mTBI care of a census of patients in the Military Health System, assessed the number and characteristics (including deployment history and history of TBI) of nondeployed, active-duty service members who received an mTBI diagnosis in 2012, the locations of their diagnoses and next health care visits, the types of care they received in the six months following their mTBI diagnosis, co-occurring conditions, and the duration of their treatment. While the majority of service members with mTBI recover quickly, the study further examined a subset of service members with mTBI who received care for longer than three months following their diagnosis. Diagnosing and treating mTBI can be especially challenging because of variations in symptoms and other factors. The research revealed inconsistencies in the diagnostic coding, as well as areas for improvement in coordinating care across providers and care settings. The results and recommendations provide a foundation to guide future clinical studies to improve the quality of care and subsequent outcomes for service members diagnosed with mTBI.
How Many Service Members Receive Treatment for mTBI?
What Are the Characteristics of Nondeployed Active-Duty Service Members Who Receive Treatment for an mTBI Through the MHS?
Where Do Nondeployed Active-Duty Service Members with mTBI Receive Care?
What Are the Duration and Patterns of Health Care in the Six Months After an mTBI Diagnosis?
What Types of Care Do Nondeployed Active-Duty Service Members with mTBI Receive in the Six Months After Their mTBI Diagnosis?
Who Receives Persistent Care Following mTBI Diagnosis?
Findings and Recommendations
Using ICD-9 Codes to Identify mTBI
Comparison and Variation Using the Project and Other ICD-9 Definitions
ICD-9 to ICD-10 Considerations
This research was sponsored by the Defense and Veterans Brain Injury Center in the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury and conducted within the Forces and Resources Policy Center of the RAND National Defense Research Institute, a federally funded research and development center sponsored by the Office of the Secretary of Defense, the Joint Staff, the Unified Combatant Commands, the Navy, the Marine Corps, the defense agencies, and the defense Intelligence Community.
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