At a time when they likely need it most, people with traumatic brain injuries (TBI) are more likely to lose their private health insurance coverage or see changes in it, a new analysis has found.

American researchers pored over three years’ worth of data and discovered that the more severe a patient’s brain injury, the quicker he or she is likely to lose or see changes in health coverage. Since most people get health insurance through their employment, changes in coverage emerged mostly due to changes in employment.

Study author Eric Schneider from Brigham and Women’s Hospital told Reuters that primary policyholders might have lost their coverage due to an inability to continue working and eventually becoming unemployed.

Traumatic brain injuries lead to 280,000 hospitalizations every year in the United States alone, with a staggering 2.5 million emergency room visits. About 40 percent of survivors become disabled, disrupting their capacity to work and everyday routine.

Investigating data from national health insurance database MarketScan, the team compared over 13,500 individuals – under 65 years old and treated for TBI – to individuals who did not experience the same condition from January 2010 to December 2012.

According to the results, 30.7 percent of TBI patients had changes in their health insurance coverage versus 27.6 percent of those without the injury.

In the most severely injured, too, insurance changes could occur in under five months from the time of injury. Compare this with individuals without TBI who averaged around 8.5 months before shifts in their health coverage.

It was unclear as to why the participants exactly changed insurance status — it could be due to factors like disability-based eligibility for various insurance programs, said Schneider.

The findings are deemed important since ongoing healthcare is crucial to these patients, especially since they are often treated long after their brain injury took place.

“Some of these patients receive prolonged rehabilitation,” said neurosurgeon Dr. Kimon Bekelis, who deemed the findings a wake-up call for payers, doctors, and policy makers about the dangers of inefficient healthcare provision.

Dr. Bekelis, who was not involved in the analysis, said that many of these patients are prescribed long-term drugs and may even suffer seizures. Disrupted or no insurance coverage could spell catastrophe for them and their dependents, the doctor warned.

The findings were published in the journal JAMA Surgery.

External forces that could lead to TBI include bumps to the head, a foreign object penetrating the skull, or violent bouncing of twisting of the brain inside the skull due to a rapid jolt. Concussions qualify as mild or moderate TBI.

According to the U.S. Centers for Disease Control and Prevention, falls accounted for 40 percent of all TBI cases from 2006 to 2010, while being hit by an object and other unintentional blunt trauma followed with 15 percent. Motor vehicle accidents were the third leading cause at 14 percent, while around 10 percent resulted from assaults.

Even mild brain injury should be taken seriously, as up to 90 percent of related deaths, emergency room visits, and hospitalizations are classified as mild cases such as concussions.

Photo: Army Medicine | Flickr

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