Managing costs and outcome of patients with traumatic brain injury in an HMO setting

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The Northern California Kaiser Permanente Medical Care program is a federally qualified health maintenance organization (HMO) dedicated to providing quality health care at reasonable cost. One hundred forty-one Kaiser patients with traumatic brain injury (TBI) were studied with respect to employment, living, and functional status. Costs at each level of care were estimated. Mean length of stay (LOS) and total cost were lowest for acute rehabilitation (19.4 days; $11,188.52) and highest for acute medical care (29.7 days; $13,363.12). Outcome measures taken at 6 to 28 months after injury indicate that 90% of patients live at home; 29% are fully employed, 5% are employed part time, and 35% are in school; and 88% function independently.

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