To address the concerns raised about repatriations (the process of patients being sent back to local hospitals after receiving treatment at a trauma centre), ONF will examine administrative data collected for an Applied Health Research Question (AHRQ) from the Institute for Clinical Evaluative Sciences (ICES). Data analysis will explore patient lengths of stay, patient trajectories of care within the system, discharge destination, serviced received, and other factors that might determine outcomes. Where possible costs of care for repatriated patients will be evaluated.
Post-Doctoral Research Fellow: Health Economist
The Centre for Addiction and Mental Health (CAMH) and ONF have jointly funded a post-doctoral research fellow to try and quantify the economic costs of concussion/mTBI and moderate-to-severe brain injury as well as explore opportunities to improve care delivery through more timely or effective interventions. The post-doctoral research fellow will develop economic evaluation models for interventions in the areas of mental health and addictions, and acquired brain injury, as well as undertake other related projects looking at the economics of TBI healthcare.
TBI Report Card
Currently, there is no report card that examines TBI indicators by region or province. By creating a report card, regional care centres will be able to measure performance against other regions and the province. Health region teams can then comment on their current state and provide recommendations for improvement. The key findings that emerge from the study will help inform implementation strategies and policy makers at the Ministry of Health and Long-Term Care (MOHLTC).
Ontario Concussion Cohort
This project identified all persons sustaining a concussion in the province of Ontario by using administrative health data held by the Institute of Clinical and Evaluative Sciences (ICES). The data represents every resident of Ontario that was diagnosed with a concussion by a public healthcare provider between 2008 and 2016.
Findings show that over 150,000 people are diagnosed every year with a concussion in Ontario. Data also shows that children under 5 years and adults over 60 have the highest incidence of concussion. Rural regions have a higher incidence of concussion than urban regions.
All persons with a concussion were tracked for 2 years to examine care received by a public provider in order to understand: number of follow up visits, wait times for specialists, and concerns of pre-injury health conditions associated with increased risk of persistent symptoms.
The pediatric population had longer wait times than adult population. Wait times were on average longer than 7 months and varied by region and type of specialist. People living in the northern parts of the province had the longest wait times. Specialists commonly seen to treat persisting post-concussion symptoms include psychiatry, physical medicine and rehabilitation, otolaryngologists (Ear Nose and Throat specialists), ophthalmology, neurology, and neurosurgery.
About 1 in 7 (13%) of the adult population with concussion required specialized care for persisting post-concussion symptoms. The demographic and premorbid health information of the adults in the cohort are currently being analyzed to determine if there are any predictive factors (i.e. prior mental health, history of migraine, sex, age, etc.) that increase the risk of adults requiring care for persisting post-concussion symptoms so we can tailor concussion treatment to this group.