Rehabilitation utilization in malignant primary brain tumors compared to stroke and traumatic brain injury: Analysis using a large claim database

IF 2.4 Q2 CLINICAL NEUROLOGY

Neuro-oncology practice Pub Date : 2024-07-16 DOI:10.1093/nop/npae064

Samantha Giovanazzi, Beatrice Ugiliweneza, Elsa Alvarez, Maxwell Boakye, Darryl Kaelin, Megan B Nelson

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Abstract

There is concern regarding the underutilization of rehabilitation services for the malignant primary brain tumor (MPBT) population following hospitalization. Our aim is to assess physical therapy (PT), occupational therapy (OT), and speech-language pathology (SLP) use after a MPBT diagnosis, evaluate the trend from 2001-2018, and compare to traumatic brain injury (TBI) and stroke. Adult cases of MPBT, TBI, and stroke were extracted from MarketScan database. Inpatient and outpatient data were screened for inpatient rehabilitation use at the time of diagnosis and post-discharge outpatient PT, OT, and SLP over 12 months. Generalized linear regressions were used for analysis. Cohort was composed of 3,381 MPBT, 205,366 stroke, and 24,825 TBI patients. After diagnosis, 1% of MPBTs were discharged to skilled nursing facilities (SNF) and 3% to inpatient rehabilitation facilities (IRF). Rehabilitation use at 12 months was 19% PT, 8% OT, and 6% SLP. These percentages were lower than stroke and TBI; stroke: 8% SNF, 8% IRF, 22% PT, 10% OT, and 8% SLP; TBI: 7% SNF, 7% IRF, 22% PT, 8% OT, and 6% SLP. Outpatient therapies increased from 2001 to 2018, with PT use consistently higher than OT and SLP. MPBT had the greatest increases in OT (7.95 times) and PT (3.89 times) compared to stroke and TBI, while stroke had the greatest increase in SLP (.98 times). MPBT patients had the highest increase of OT and PT utilization when compared to stroke and TBI. However, there remains a utilization gap which demonstrates the need for improvement.

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恶性原发性脑肿瘤与中风和脑外伤的康复利用率比较：利用大型索赔数据库进行分析

恶性原发性脑肿瘤（MPBT）患者住院后康复服务利用率不足的问题备受关注。我们的目的是评估确诊 MPBT 后物理治疗（PT）、职业治疗（OT）和言语病理治疗（SLP）的使用情况，评估 2001-2018 年的趋势，并与创伤性脑损伤（TBI）和中风进行比较。从 MarketScan 数据库中提取了 MPBT、创伤性脑损伤和中风的成人病例。对住院病人和门诊病人数据进行筛查，以了解诊断时住院康复治疗的使用情况以及出院后 12 个月内门诊治疗 PT、OT 和 SLP 的使用情况。分析中使用了广义线性回归。队列由 3,381 名 MPBT 患者、205,366 名中风患者和 24,825 名创伤性脑损伤患者组成。确诊后，1% 的 MPBT 患者出院后入住专业护理机构 (SNF)，3% 入住住院康复机构 (IRF)。在 12 个月内使用康复治疗的患者中，19% 使用 PT，8% 使用 OT，6% 使用 SLP。这些百分比低于中风和创伤性脑损伤；中风：8% SNF、8% IRF、22% PT、10% OT 和 8% SLP；创伤性脑损伤：7% SNF、7% IRF、22% PT、8% OT 和 6% SLP。从 2001 年到 2018 年，门诊治疗有所增加，其中 PT 的使用率一直高于 OT 和 SLP。与中风和创伤性脑损伤相比，MPBT 在 OT（7.95 倍）和 PT（3.89 倍）方面的增幅最大，而中风在 SLP 方面的增幅最大（0.98 倍）。与中风和创伤性脑损伤患者相比，MPBT 患者对 OT 和 PT 的使用增加最多。然而，利用率仍然存在差距，这表明需要加以改进。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuro-oncology practice CLINICAL NEUROLOGY-

CiteScore

5.30

自引率

11.10%

发文量

期刊介绍： Neuro-Oncology Practice focuses on the clinical aspects of the subspecialty for practicing clinicians and healthcare specialists from a variety of disciplines including physicians, nurses, physical/occupational therapists, neuropsychologists, and palliative care specialists, who have focused their careers on clinical patient care and who want to apply the latest treatment advances to their practice. These include: Applying new trial results to improve standards of patient care Translating scientific advances such as tumor molecular profiling and advanced imaging into clinical treatment decision making and personalized brain tumor therapies Raising awareness of basic, translational and clinical research in areas of symptom management, survivorship, neurocognitive function, end of life issues and caregiving