Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-25T23:49:50.293Z Has data issue: false hasContentIssue false
  • English
  • Français

Pressure to Progress: Severe Traumatic Brain Injury and Slow Recovery in the Current Health Care Environment

Published online by Cambridge University Press:  20 February 2017

Michele Foster ,
Cheryl Tilse  and
Jennifer Fleming
Michele Foster
Affiliation:
The University of Queensland, Australia
Cheryl Tilse
Affiliation:
The University of Queensland, Australia
Jennifer Fleming
Affiliation:
The University of Queensland, Australia
Get access

Abstract

This paper discusses issues arising from a study of referral from acute care following traumatic brain injury (TBI) in Queensland, in which aged care facilities were relied upon for the discharge of those with slow recovery after severe TBI. The discussion considers: (1) recovery following severe TBI; (2) the current policy context; (3) approaches to care beyond acute care; and (4) implications for policy and practice. In the current health care environment, with increasing pressure on scarce resources, it is critical that practitioners advocate for the dignity and care of people who sustain severe TBI and who are slow to recover.

Type
Articles
Information
The Australian Journal of Rehabilitation Counselling , Volume 8 , Issue 1 , January 2002 , pp. 20 - 29
Copyright
Copyright © Cambridge University Press 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Australian Institute of Health and Welfare. (2001). Australia's welfare 2001. Canberra: Author.Google Scholar
Andrews, K. (1993). Recovery of patients after four months in the persistent vegetative state. British Medical Journal, 12, 1597–1600.CrossRefGoogle Scholar
Ansell, B. (1993). Slow-to-recover patients: Improvement to rehabilitation readiness. Journal of Head Trauma Rehabilitation, 8, 88–98.CrossRefGoogle Scholar
Banja, J.D. (1999). Patient advocacy at risk: Ethical, legal and political dimensions of adverse reimbursement practices in brain injury rehabilitation in the US. Brain Injury, 13, 745–758.Google Scholar
Banja, J., & Moore, G. (1997). Shifting burdens in managed care: But to whom? Journal of Head Trauma Rehabilitation, 12(3), 91–95.Google Scholar
Batavia, A.I. (1993). Health care reform and people with disabilities. Health Affairs, 12, 40–57.Google Scholar
Blades, D.A., & Harley, D.A. (1997). Vocational and medical rehabilitation: The impact of health care policy and funding on service provision. The Journal of Rehabilitation, 63, 35–39.Google Scholar
Bricolo, A., Turazzi, S., & Feriotti, G. (1980). Prolonged posttraumatic unconsciousness. Journal of Neurosurgery, 52, 625–634.CrossRefGoogle ScholarPubMed
Cameron, C. (2000). Long-term care of younger people with severe acquired brain injury: Appropriateness of aged care facilities. Unpublished master's thesis. The University of Queensland, Brisbane, Australia.Google Scholar
Commonwealth Department of Health and Family Services. (1997). Assessment and entry to nursing homes and hostels of young people with disabilities. Canberra: Commonwealth Department of Health and Family Services, Aged and Community Care Division.Google Scholar
Courtney, M., Minichiello, V., & Waite, H. (1997). Aged care in Australia: A critical review of the reforms. Journal of Aging Studies, 11, 229–250.CrossRefGoogle Scholar
Department of Human Services. (1997). Rehabilitation into the 21st century: A vision for Victoria. Victoria: Department of Human Services, Aged Care Division.Google Scholar
Draper, M. (1999). Casemix: Financing hospital services. In Hancock, L. (Ed.), Health policy in the market state (pp. 131–148). St Leonards: Allen & Unwin.Google Scholar
Duchene, P.A. (1995). Comprehensive medical rehabilitation: The tincture of time. Journal of Rehabilitation Administration, 19, 251–252.Google Scholar
Eker, C., Schalén, W., Asgeirsson, B., Grände, P-O., Ranstam, J., & Nordström, C.H. (2000). Reduced mortality after severe head injury will increase the demands for rehabilitation services. Brain injury, 14(7), 605–619.Google Scholar
Fearnside, M., Cook, R., McDougall, P., & McNeil, R. (1993). The Westmead head injury project. Outcome in severe head injury. A comparative analysis of per-hospital, clinical and CT variables. British Journal of Neurosurgery, 7, 267–280.Google Scholar
Finch, J., & Blumke, D. (1999). Interim report on the ‘State-wide plan for rehabilitation services in Queensland: 2000–2005’. Brisbane: Queensland Health.Google Scholar
Fortune, N., & Wen, X. (1999). The definition, incidence and prevalence of acquired brain injury in Australia. Australian Institute of Health and Welfare, AIHW cat. No. DIS 15. Canberra: AIHW.Google Scholar
Foster, M., Fleming, J., Tilse, C., & Rosenman, L. (2000). Referral to post-acute care following traumatic brain injury in the Australia context. Brain injury, 14(12), 1035–1045.Google Scholar
Freeman, E.A. (1997). Community-based rehabilitation of the person with a severe brain injury. Brain Injury, 11(2), 143–153.Google Scholar
Giles, G.M. (1994). The status of brain injury rehabilitation. American Journal of Occupational Therapy, 48, 199–205.Google Scholar
Harris, L., & Richardson, J. (1994). Pressure for health care reform: The international context. The Medical Journal of Australia, 160, 463–465.Google Scholar
Hauber, R.P., & Testani-Dufour, L. (2000). Living in limbo: The low level brain-injured patient and the patient's family. Journal of Neuroscience Nursing, 32(1), 22–26.CrossRefGoogle ScholarPubMed
Jackson, J.D. (1993). After rehabilitation: Meeting the long-term needs of persons with traumatic brain injury. The American Journal of Occupational Therapy, 48, 251–255.Google Scholar
Jennett, B. (1997). A quarter century of the vegetative state: An international perspective. Journal of Head Trauma Rehabilitation, 12, 1–12.Google Scholar
Johnston, C., & Standford, M. (1996). Swapping health care systems: Whose grass is really greener? (Editorial). The Journal of the American Medical Association, 276(24), 1986–1987.Google Scholar
Kothmann, W. (1995). Is subacute care feasible? Healthcare Financial Management, 49(10), 60–66.Google ScholarPubMed
Kendall, E. (1991). Acquired brain damage: A review of service provision in Queensland. Brisbane: Department of Community Services and Health.Google Scholar
Levenson, S. (1998). Subacute settings: Making the most of a new model of care. Geriatrics, 53(7), 69.Google ScholarPubMed
Master, R., & Eng, C. (2001). Integrating acute and long-term care for high-cost populations. Health Affairs, 20(6), 161–172.CrossRefGoogle ScholarPubMed
Max, W., Mackenzie, E.J., & Rice, D. (1991). Head injuries: Costs and consequences. Journal of Head Trauma Rehabilitation, 6, 76–91.Google Scholar
Mazaux, J.M., & Richer, E. (1998). Rehabilitation after traumatic brain injury in adults. Disability and rehabilitation, 20, 435–447.Google Scholar
McLennan, W. (1993). Disability, ageing and carers: Brain injury and stroke. Canberra: Australian Bureau of Statistics. Cat. No. 4437.0, AGPS.Google Scholar
McMillan, T.M. (1996). Neuropsychological assessment after extremely severe head injury in a case of life or death. Brain Injury, 11(7), 483–490.Google Scholar
Mooney, G. (1998). Beyond health outcomes: The benefits of health care. Health Care Analysis, 6, 99–105.Google Scholar
Phipps, E.J., Di Pasquale, M., Blitz, C.L., & Whyte, J. (1997). Interpreting responsiveness in persons with severe traumatic brain injury: Beliefs in families and qualitative evaluations. Journal of Head Trauma Rehabilitation, 12, 52–69.Google Scholar
Tennant, A., MacDermott, N., & Neary, D. (1995). The long-term outcome of head injury: Implications for service planning. Brain Injury, 9, 595–605.CrossRefGoogle ScholarPubMed
Walker, W.C., Kreutzer, J.S., & Witol, A.D. (1996). Level of care options for the low-functioning brain injury survivor. Brain Injury, 10(1), 65–75.Google Scholar
Wallace, P.E. (1994). Post-hospital care for the underserved: A review. Journal of Health Care for the Poor and the Underserved, 5, 316–325.Google Scholar
Wellington, C. (1993). A historic, geographic, cultural, and economic guide to Australian health care. Physician Executive, 19(3), 14–22.Google Scholar
Wrigley, J.M., Yoels, W.C., Webb, C.R., & Fine, P.R. (1994). Social and physical factors in the referral of people with traumatic brain injuries to rehabilitation. Archives of Physical Medicine and Rehabilitation, 75(02), 149–155.Google Scholar