OBJECTIVE: To examine the unique contribution of self-reported medical comorbidity and insurance type on disability following traumatic brain injury (TBI).
DESIGN: Inception cohort design at one-year follow up. Setting: The Rehabilitation Institute of Michigan (RIM). Participants: Seventy-adults with mild-complicated to severe TBI. MAIN OUTCOME MEASURES: Self-reported medical comorbidities were measured using the Modified Cumulative Illness Rating Scale (MCIRS) while insurance type was classified as commercial or government-funded; disability was measured using the Disability Rating Scale (DRS).
RESULTS: Two models were run using multiple linear regression and the best fitting model was selected based on the Bayesian Information Criterion (BIC). The full model which included self-reported medical comorbidity and insurance type was significantly better fitting than the reduced model. Participants with longer duration of posttraumatic amnesia, more self-reported medical comorbidities, and government insurance were more likely to have higher levels of disability. Meanwhile, individual organ systems were not predictive of disability.
CONCLUSIONS: The cumulative impact of self-reported medical comorbidities and type of insurance coverage predict disability above and beyond well-known prognostic variables. Early assessment of medical complications and improving services provided by government-funded insurance may enhance quality of life and reduce long-term health care costs.