Objective
To examine the use of primary care (PCP) and brain injury physicians in the years after a traumatic brain injury (TBI) and the perceived reasons for lack of utilization.
Design
Prospective, observational cohort study of persons who received inpatient brain injury rehabilitation under the care of a brain injury rehabilitation physician.
Setting
Fifteen TBI Model System centers.
Participants
Participants in the TBI Model Systems (N=1520) cohort who experienced TBI 1-35 years previously.
Interventions
Not applicable.
Main Outcome Measures
The proportion of participants under the care of a PCP and/or a brain injury physician, and if applicable, the reasons not cared for by a physician; and what type of physician the participant would see if they had 8 common brain injury conditions.
Results
Most participants (85%) reported having a PCP, and 35% reported active care from a brain injury physician. More than 90% have visited their physician in the past 1-2 years. Factors independently associated with not having either a PCP or a brain injury physician were being younger, men, black, unmarried, having fewer health conditions, and having a more rapid initial recovery from their TBI. The most frequent reasons for not having a specific type of physician were a lack of perceived need or their physician taking care of most of their health care problems. The PCP was most often the first contact for 8 common health conditions.
Conclusions
Most individuals in this longitudinal cohort of TBI survivors report having a PCP. Demographic and clinical characteristics identified subgroups who may lack regular contact with primary care or brain injury specialty care. While all participants were cared for by a brain injury physician during their initial rehabilitation, only a minority had ongoing care from a brain injury physician years later.
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