Good care costs money and is predicated on the commitment to standard guidelines. Unfortunately, it varies greatly across the country.
Turn Text Only Off
Page Utilities
Click on any phrase to play the video at that point.
I think, in terms of the quality of care and the consistency of care, it remains quite variable
throughout the United States.
I think that there are communities and
areas that have focused
heavily on this and invested resources in it
and committed to following,
for example, the American College of Surgeons
Committee on Trauma Guidelines
and submitted themselves
to site surveys by the Committee on Trauma.
I think that the quality of care at those centers
has been shown to be
much better than the quality of care at
other locations that have decided not to commit to that
or commit the resources necessary for that.
So it depends on the area of the United States.
Obviously, I'm not going to talk about what areas those are,
but it does.
And it is, unfortunately, still not consistent.
I think that for brain injury in particular,
more than any hypothermia treatment
or any specific treatment, per se,
the key is consistent, high-level
care that is
based on the best available
studies and the best available guidance.
And we have a pretty good idea of what that care is right now.
A number of groups, most especially the
Brain Trauma Foundation several years ago,
have spent a great deal of time and effort to
sort out what is the
optimal care for a brain injured patient
and what's not so optimal care.
[What are signs of high-quality rehabilitation programs?]
They start with an inpatient program with
physiatrists or physical medicine rehabilitation specialists
coordinating the rehab who are trained
in head injury rehab,
know what they're doing.
Those who are skilled and those who are dedicated.
It's an inpatient program, at least for 3, 4, 5 months, ideally,
and then aggressive outpatient therapy with frequent
outpatient visits
and just a devoted team.
But it's expensive.
It costs money, and unfortunately
most insurance plans don't cover that
sort of extensive rehab.
Typically, what you see is that they will expect,
if not weekly, certainly
monthly, measurable changes,
and often change is according to the Ranchos Los Amigos scale.
Well, the Ranchos Los Amigos scale
of functionality is a very, very crude scale.
It's only an 8-point scale.
To improve one number on that scale
can mean a massive improvement
that's completely unrealistic over
the course of a week or a month.
But as you can imagine,
insurance companies will want to glom on to that and say,
"Well, we expect that much change or we won't pay for it."
Produced by Noel Gunther and Brian King, BrainLine.
Donald Marion, MD, MSc is director of Clinical Affairs, The Defense and Veterans Brain Injury Center, and contractor with the Henry M. Jackson Foundation for the Advancement of Military Medicine. He is an academic neurosurgeon who has focused on the clinical pathophysiology and treatment of traumatic brain injury for more than 25 years.
The contents of Brainline (the “Web Site”), such as text, graphics, images, information obtained from the Web Site’s licensors and/or consultants, and other material contained on the Web Site (collectively, the “Content”) are for informational purposes only. The Content is not intended to be a substitute for medical, legal, or other professional advice, diagnosis, or treatment.
Specifically, with regards to medical issues, always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the Web Site. If you think you may have a medical emergency, call your doctor or 911 immediately. The Web Site does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Web Site. Reliance on any information provided by the Web Site or by employees, volunteers or contractors or others associated with the Web Site and/or other visitors to the Web Site is solely at your own risk.
Related Content
Audio/Video:
Learn what therapeutic hypothermia is and how it can help people with a severe TBI immediately following the initial impact of injury.- What Is Therapeutic Hypothermia?
- Cooling people who have sustained a brain injury is not new therapy. But, it is getting more advanced, and the risks are minimal.
- Therapeutic Hypothermia for People with Brain Injury
- Results from a neurospychological exam conducted soon after a TBI will help formulate the rehabilitiation plan.
- Early Neuropsych Evaluation Helps Formulate Rehab Plan
- Rehab can run the gamut from residential nursing homes to vocational rehab instruction. Cost is often the biggest impediment, but there are resources to help.
- Options for Rehab After a Brain Injury
- Most rehab facilities specialize. Make sure to ask lots of questions to find the right one for you or your loved one.
- Selecting the Right Rehabilitation Facility After Brain Injury
- When it comes to rehab after TBI, the earlier the better — and the more thorough, the better the outcome. Transcript of this video.
- When do you Begin the Rehab Process?
Articles:
- Choosing a High-Quality Medical Rehabilitation Program
- An Introduction to Rehabilitation: The Healing Brain
- Traumatic Brain Injury and Acute Inpatient Rehabilitation
- What Determines Rehab Length of Stay After Brain Injury?
- Vision and Rehabilitation After Brain Trauma (Part 1)
- Who Are the Rehab Specialists?
BrainLine Footer
Getting Started |
Site Features |
Follow Us |
About |
Facebook
Twitter
LinkedIn
YouTube
RSS Feeds
BrainLine.org is a WETA website funded by the Defense and Veterans Brain Injury Center through a contract with the Henry M. Jackson Foundation. Government funding support is not an endorsement of WETA or any of its products, including this website.
© 2013 WETA All Rights Reserved
