Cognitive reserve and disparities in healthcare usage after traumatic brain injury and stroke: an observational cohort study.

IF 2.5 4区医学 Q1 REHABILITATION

Journal of Rehabilitation Medicine Pub Date : 2025-05-13 DOI:10.2340/jrm.v57.42400

Natascha Ekdahl, Marianne Lannsjö, Britt-Marie Stålnacke, Marika Möller

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引用次数: 0

Abstract

Background: Individuals with more education commonly have better outcome after brain injury, often attributed to cognitive reserve. However, evidence suggests that individuals with more education have better access to specialized care, potentially affecting outcomes.

Objective: To investigate differences in healthcare usage based on cognitive reserve and examine the relationship between healthcare usage and outcomes after stroke and traumatic brain injury.

Design: An observational cohort study with healthcare usage data from 3 years before to 4 years after injury, interviewing patients 5-15 years after injury.

Patients: A total of 83 participants suffering a stroke or traumatic brain injury.

Results: Healthcare usage over time varied based on educational level (repeated measures ANOVA, F(2, 227) = 4.17, p = 0.008). The differences in healthcare usage between educational levels was significant during the injury year (F(81) = -5.47, p = 0.022). Higher education implied more healthcare usage. Linear regression, controlling for possible confounders, confirmed the relationship between education and healthcare usage, (β = 4.3, p = 0.022). Healthcare usage was significantly related to long-term life satisfaction, but not to return to work.

Conclusion: Individuals with more education received more healthcare in the year after traumatic brain injury or stroke. However, this was not related to long-term outcome regarding return to work, but we found a relationship between healthcare usage and life satisfaction.

查看原文本刊更多论文

创伤性脑损伤和脑卒中后认知储备和医疗保健使用的差异：一项观察性队列研究。

背景：受教育程度越高的个体通常在脑损伤后预后越好，这通常归因于认知储备。然而，有证据表明，受过更多教育的人更容易获得专业护理，这可能会影响结果。目的：探讨脑卒中和创伤性脑损伤患者认知储备在医疗保健使用方面的差异，探讨医疗保健使用与预后的关系。设计：一项观察性队列研究，采用损伤前3年至损伤后4年的医疗保健使用数据，访谈损伤后5-15年的患者。患者：共有83名参与者患有中风或创伤性脑损伤。结果：医疗保健使用率随教育水平的变化而变化（重复测量方差分析，F(2,227) = 4.17, p = 0.008）。在受伤年度，不同教育程度的患者在医疗保健使用方面存在显著差异（F(81) = -5.47, p = 0.022）。高等教育意味着更多的医疗保健使用。线性回归控制了可能的混杂因素，证实了教育与医疗保健使用之间的关系（β = 4.3, p = 0.022）。医疗保健使用与长期生活满意度显著相关，但与重返工作岗位无关。结论：受教育程度越高的个体在颅脑损伤或脑卒中后一年获得的医疗服务越多。然而，这与重返工作岗位的长期结果无关，但我们发现医疗保健使用与生活满意度之间存在关系。

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

Journal of Rehabilitation Medicine 医学-康复医学

CiteScore

5.60

自引率

5.70%

发文量

102

审稿时长

4-8 weeks

期刊介绍： Journal of Rehabilitation Medicine is an international peer-review journal published in English, with at least 10 issues published per year. Original articles, reviews, case reports, short communications, special reports and letters to the editor are published, as also are editorials and book reviews. The journal strives to provide its readers with a variety of topics, including: functional assessment and intervention studies, clinical studies in various patient groups, methodology in physical and rehabilitation medicine, epidemiological studies on disabling conditions and reports on vocational and sociomedical aspects of rehabilitation.