Do young people with neurological conditions in residential aged care use hospitals differently than those in the community? Evidence from Victorian hospital data, 2014-2017

This study describes the duration and reasons for hospitalisation for three cohorts of younger adults with neurological conditions who either used residential aged care (RAC) or lived in the community. Hospitalisations as a clinical event indicate conditions for which younger people in RAC may need support as they move into community-based housing. Data describing 3 years of hospitalisations in Victorian public hospitals and emergency departments were used. The neurological conditions occurring among the three cohorts include (1) Cerebral Vascular Accident (CVA), (2) Traumatic Brain Injury (TBI) and (3) Multiple Sclerosis (MS). Frequency of hospitalisation, length of stay and leading causes of potentially preventable hospitalisations were examined. Two hundred and fifty-two (2.7%) of 9333 patients hospitalised for these neurological conditions subsequently used RAC. Hospitalisations were more frequent for those using RAC compared to those living in the community for cohorts with CVA and TBI (6.26 vs. 2.65 events per person-year for CVA and 4.34 vs. 1.88 for TBI) while hospitalisations were more frequent among those in the community compared to those using RAC for the cohort living with MS (3.62 vs. 5.35 per person-year). However, for all the cohorts, the average length of acute hospital stays was longer among RAC users than among those in the community (19.6 vs. 6.2 days for CVA, 15.5 vs. 4.5 for TBI and 12.2 vs. 7.0 for MS). Leading causes for hospitalisation were complex comorbidities and changes in health status (such as seizures, ulcers, dehydration and cellulitis). Efforts should be made to design supports and proactively manage health needs leading to these hospitalisations.

Outcomes of participation objective, participation subjective (POPS) measure following traumatic brain injury

PRIMARY OBJECTIVE

To investigate the participation of adults living with traumatic brain injury in regional and rural NSW as measured by the Participation Objective Participation Subjective (POPS) measure.

RESEARCH DESIGN

A quantitative survey of a single cohort as the first of a two phase mixed methods study.

METHODS AND PROCEDURES

One hundred and thirty-one adults with a TBI were recruited through eight rural brain injury rehabilitation programmes in NSW. These adults completed a range of survey instruments, including the POPS.

MAIN OUTCOMES AND RESULTS

The POPS measure supported findings from other research that identified varying impacts of TBI. However, in contrast to other studies, there was no correlation between participation scores and age, gender, time since injury and severity of injury.

CONCLUSIONS

The findings from this study suggest that the issue of participation of adults with TBI living in non-metropolitan areas needs to be further researched.