Association of Polytrauma Care and Primary Care With Utilization of Health Services for Veterans With Traumatic Brain Injury.

OBJECTIVE

To examine the association between primary care (PC) and/or polytrauma care (PTr) with health services utilization in veterans with traumatic brain injury (TBI).

DESIGN

Retrospective analysis of data from the Long-term Impact of Military-Relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium Phenotype study cohort.

SETTING

Veterans Health Administration.

PARTICIPANTS

Veterans after the TBI-related first encounter in the Veterans Health Administration (VA) system for 4 groups: control; received only PC, but no PTr; received only PTr, but no PC; and received both PC+PTr.

INTERVENTIONS: None.

MAIN OUTCOME MEASURES: Three-year utilization of subsequent emergency department, inpatient, and outpatient services.

RESULTS

The cohort of veterans with TBI who received both PC and PTr had the most decline in their VA-provided health services utilization (emergency, inpatient, and outpatient). For the non-VA health services utilization, the trends were mixed and inconclusive.

CONCLUSIONS

Veterans who had frontloading of both PC and PTr had the most significant decline in subsequent VA-provided health services utilization, whereas trends for non-VA health services utilization were mixed and inconclusive. To enhance care coordination and outcomes, the Veterans Health Administration could implement integrated care models that promote collaboration between PC providers and polytrauma teams. This approach may optimize resource use and improve long-term recovery and health stability for veterans with TBI.