Perceived health after adult traumatic brain injury: a Group-Based Trajectory Modeling (GBTM) analysis
Bradford C. Feldman, Jiabin Shen, Cheng Chen, Junxin Shi, Henry Xiang
Abstract
OBJECTIVE: To provide nationally representative estimates of adults with traumatic brain injury (TBI) and identify clusters of individuals with TBI who follow similar perceived health trajectories using group-based trajectory modeling. PARTICIPANTS: Adults (≥18 years old) from panels 9-19 (2004-2015) of the Medical Expenditure Panel Survey (MEPS) who experienced a TBI (n = 949). DESIGN: Data from MEPS, a nationally representative database of noninstitutionalized individuals in the USA, were used to 1) produce a national annual estimate of adults with TBI and 2) identify subgroups of patients with TBI who followed different general and mental health trajectories. MAIN MEASURES: Perceived general health (PGH), perceived mental health (PMH). RESULTS: On average, 502 adults per 100,000 noninstitutionalized US adults experienced a TBI annually, and about one million adults are living with a TBI. Three distinct trajectory groups were identified in models of both perceived general health (PGH) and perceived mental health (PMH). TBI type, sex, and persistent disability predicted assignment to a group in the PGH model. TBI type, sex, age, insurance status, family poverty status, and persistent disability predicted assignment to a PMH trajectory. CONCLUSION: Referrals and early-intervention resources should be distributed to individuals with increased risk of following low PGH and/or PMH trajectories.