Access to health services for moderate to severe TBI in Indiana: patient and caregiver perspectives.

Publisher: Informa Healthcare Country of Publication: England NLM ID: 8710358 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1362-301X (Electronic) Linking ISSN: 02699052 NLM ISO Abbreviation: Brain Inj

Publication: London : Informa Healthcare
Original Publication: London ; New York : Taylor & Francis, c1987-

Brain Injuries, Traumatic/*rehabilitation ; Caregivers/*psychology ; Continuity of Patient Care/*statistics & numerical data ; Health Services Accessibility/*statistics & numerical data ; Trauma Centers/*organization & administration; Adult ; Aged ; Aged, 80 and over ; Brain Injuries, Traumatic/physiopathology ; Brain Injuries, Traumatic/psychology ; Continuity of Patient Care/organization & administration ; Female ; Health Services Accessibility/organization & administration ; Health Services Needs and Demand ; Humans ; Indiana ; Life Change Events ; Male ; Middle Aged ; Policy Making ; Qualitative Research ; Social Support ; Young Adult

Objective: We examined patient and caregiver experiences of health services for moderate to severe traumatic brain injury (TBI) in Indiana. The objective was to provide an understanding of their lived experiences and to inform policies and practices for health services delivery for TBI.
Methods: We conducted qualitative, semi-structured interviews with 62 participants (34 patients and 28 caregivers). Data analysis was guided by constructive grounded theory.
Results: Three interrelated themes emerged from the data and characterised participants' experiences accessing health services for TBI: 1) inadequate access to health services; 2) unavailability of specialised, age-appropriate, and long-term health services; and 3) transportation barriers to health services that limit access to care and amplify rural health disparities for patients.
Conclusion: Our findings identified significant barriers to health services for patients with TBI at different points in the care continuum. Gaps in health services and barriers to care transcend geographical boundaries within the state. We suggest ways to improve access to TBI care including: 1) decentralisation of trauma centers; 2) development of neurobehavioural and age-appropriate long-term care facilities; 3) increased workforce with expertise in TBI treatment; and 4) improved access to transportation services for patients with a TBI.

IK2 RX000879 United States RX RRD VA

Keywords: Traumatic brain injury; access to care; caregivers; health services delivery; qualitative research

Date Created: 20180724 Date Completed: 20190820 Latest Revision: 20210622

20231215

10.1080/02699052.2018.1499964

30036117