Self-Report of Outpatient Therapy Dose at 6 and 12 Months After Severe Traumatic Brain Injury

Publication date: Available online 22 December 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Tessa Hart, John Whyte, Monica Vaccaro, Amanda R. Rabinowitz

Abstract

Objective

Determine agreement between self-reported dose and dose reflected in administrative records of outpatient Physical, Occupational, and Speech Therapies at 6 and 12 months after severe traumatic brain injury (TBI), for the purpose of examining accuracy and predictors of accuracy of self-reported healthcare utilization in this population.

Design

Secondary analysis of survey used in a larger study; participants were queried about therapy doses using a structured interview, either alone or assisted by relatives if they so chose, with responses compared to administrative records.

Setting

Rehabilitation center providing outpatient TBI therapies.

Participants

65 people with severe TBI living in the community provided 6-month data; 54 provided 12-month data.

Interventions

Not applicable.

Main Outcome Measure

Degree of agreement with administrative records of scheduled and billed therapy appointments, measured using intraclass correlation (ICC), with linear regression used to predict accuracy from demographic variables and cognitive status.

Results

ICCs were in the moderate range at 6 months, but were more variable, with some in the poor range, at 12 months. Agreement was higher for scheduled than for billed (attended) appointments. Assisted and unassisted patients provided comparable agreement with records. No demographic factors were associated with accuracy, but lower Cognitive FIM scores, as hypothesized, tended to predict lower agreement at 6 months.

Conclusions

People with severe TBI can provide reasonable estimates of commonly prescribed outpatient therapy doses at 6 months postinjury. Accuracy may be improved by inviting patients to request assistance from relatives and by asking them to consider attended (vs. scheduled) sessions.

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