Appendix C– Characteristics of People in TBI Rehabilitation Due to Motorcycle Crashes and Associated Costs

Characteristics of People in TBI Rehabilitation Due to Motorcycle Crashes
Of the 227 rehabilitation patients who incurred TBI in motorcycle crashes, 91.2 percent were male and 8.8 percent were female. This group was 79.2 percent White, 17.3 percent Black, and 3.5 percent Hispanic. The ages are listed in Table 1. Consistent with the ages of the TBI patients, in 1998 the mean age of a motorcycle owner was 38.1 years and the mean age of motorcyclists killed in fatal crashes was 34.6.

Table 1. Age Distribution of Rehabilitation Patients with TBI Incurred in Motorcycle Crashes

Age

Percent

16–24

26.9%

25–44

51.1%

45–64

20.7%

>65

1.3%


Diagnosis Breakdown for Motorcyclists

For the 227 people diagnosed with Traumatic Brain Injury as a result of a motorcycle crash, across three diagnosis categories, Table 2 shows the mean acute care lengths of stay varied from 20.8 to 22.9 days. Mean LOS for rehabilitation was longer, ranging from 29.3 to 32.5 days. Surprisingly, spinal cord injury co-morbidity did not noticeably affect the LOS or rehabilitation charges.

The charges per day were much higher for acute care than for rehabilitation. The ratio of charges per day for rehabilitation to acute care ranged minimally, from 0.30 to 0.31, suggesting that the overall mean of 0.31 can be applied to all TBI rehabilitation. The ratio of charges per patient for rehabilitation to acute care weigh in both cost and length of stay variations. They ranged from 0.47 for skull fracture without spinal cord injury to 0.55 for TBI plus spinal cord injury to 0.56 for concussion without spinal cord injury.

Table 2. LOS and Charges for People with TBI Incurred in Motorcycle Crashes,
by Diagnosis Group

 

Concussion – No Spinal Cord Injury

Skull Fracture-No Spinal Cord Injury

TBI + SCI

Motorcycle Patients

N = 127

N = 90

N = 10

LOS Before Rehabilitation (Mean/ Standard Deviation)

21.31
(15.61)

22.92
(18.21)

20.80
(14.04)

LOS Rehabilitation
(Mean/SD)

32.10
(24.15)

29.33
(27.32)

32.50
(20.77)

Charges Per Day – Acute Care (Mean, SD)

$5,507.24
(3,378.37)

$5,549.57
(2,775.69)

$6,279.46
(4,413.90)

Charges Per Day-Rehab (Mean, SD)

$1,408.52
(459.48)

$1,364.27
(382.51)

$1,488.55
(585.62)

Ratio Of Charges Per Day – Rehab/Charges Per Day – Acute Care (Mean, SD)

.3076
(.1424)

.3128
(.2041)

.2979
(.1200)

Ratio Of Charges Per Patient – Rehab/Charges Per Patient – Acute Care (Mean, SD)

.5602
(.4697)

.4704
(.6594)

.5520
(.3723)


Demographic Breakdowns for Motorcyclists
Table 3 shows that the LOS was nearly identical for ages 25–44 and 45–64. The LOS for patients aged 16–24 was higher (36 days compared to approximately 29 days). The data contains only three motorcyclists over age 65, too few cases to credibly report.

Table 3. LOS and Charges for People with TBI Incurred in Motorcycle Crashes, by Age Group

 

16–24

25–44

45–64

Motorcycle Patients

N = 61

N = 116

N = 47

LOS Rehab (Mean/SD)

35.62
(27.42)

29.36
(26.31)

29.68
(19.04)

Charges Rehab – (Mean/SD)

$46,997.97 (36,390.29)

$40,482.72 (41,897.63)

$43,380.77 (30,753.98)

Ratio of Charges Per
Day - Rehab/Charges Per Day - Acute Care (Mean, SD)

.3180
(.1948)

.2984
(.1689)

.3195
(.1165)

Ratio of Charges Per Patient – Rehab/ Charges per Patient – Acute Care (Mean, SD)

.5803
(.5251)

.4881
(.5829)

.5555
(.4882)


The rehabilitation charges for ages 16 to 64 range from $40,482 to $46,997. The ratio of charges per day for rehabilitation to acute care range from .30 to .32, and the ratio of charges per patient for rehabilitation to acute care range from .49 to .58.

As shown in Table 4, mean LOS for white patients was 32 days, compared to 28 for African American patients and 19 for Hispanic patients. The number of Hispanic cases (8) may be too small to be reliable. The observed differences could indicate a more rapid recovery, but differential access to payment for rehabilitation services seems a more likely explanation. The mean charges for rehabilitation range from a low of $25,394 for Hispanic patients to a high of $44,490 for white patients.

Table 4. LOS and Charges for People with TBI Incurred in Motorcycle Crashes,
by Race/Ethnicity

 

White

Black

Hispanic

Motorcycle Patients

N = 179

N = 39

N = 8

LOS rehab
(Mean/SD)

32.10
(27.29)

28.41
(14.66)

19.38
(13.70)

Charges rehab
(Mean/SD)

$44,490.64
(41,347.10)

$37,094.28
(20,696.84)

$25,394.63
(17,229.33)

Ratio of Charges Per Day – Rehab/ Charges Per Day –Acute Care (Mean, SD)

.3176
(.1738)

.2699
(.1202)

.2846
(.1750)

Ratio of Charges Per Patient – Rehab / Charges per Patient – Acute Care (Mean, SD)

.5326
(.5812)

.4773
(.3230)

.5986
(.4869)


Table 5 shows that there were no significant differences in LOS and charges by gender.

Table 5. LOS and Charges for People with TBI Incurred in Motorcycle Crashes, by Gender

 

Male

Female

Motorcycle Patients

N = 207

N = 20

LOS rehab
(Mean/SD)

31.15
(25.34)

29.47
(25.11)

Charges rehab
(Mean/SD)

$42,874.26
(38,511.74)

$38,878.26
(34,191.44)

Ratio of Charges Per Day – Rehab/ Charges Per Day –Acute Care (Mean, SD)

.3077
(.1647)

.3232
(.1909)

Ratio of Charges Per Patient – Rehab / Charges per Patient – Acute Care (Mean, SD)

.5249
(.5570)

.5363
(.4105)