Studies from University of California San Francisco (UCSF) Have Provided New Information about Traumatic Brain Injury (Insurance Payer Is Associated With Length of Stay After Traumatic Brain Injury): Central Nervous System Diseases and Conditions – Traumatic Brain Injury

2025 MAY 16 (NewsRx) -- By a News Reporter-Staff News Editor at Hospital & Nursing Home Daily -- Investigators discuss new findings in Central Nervous System Diseases and Conditions - Traumatic Brain Injury. According to news reporting from San Francisco, California, by NewsRx journalists, research stated, “Timely provision of postacute care (PAC) rehabilitation is critical for achieving functional recovery aftertraumatic brain injury (TBI). Medicaid coverage is a predictor of prolonged hospital length of stay (LOS) after TBI, a proxy for decreased PAC access.”

Financial support for this research came from Mercatus Center at George Mason University.

The news correspondents obtained a quote from the research from the University of California San Francisco (UCSF), “Among Medicaid patients with TBI, it is unknown whether coverage under a managed care organization (MCO) or fee-for-service (FFS) model predicts differences in LOS. Discharge data for patients with TBI from 318 California hospitals between 2017 and 2019 were obtained. We used multivariable regression models, treating mortality/hospice disposition as competing risks, to evaluate associations between insurance type and LOS, adjusting for sociodemographic factors and illness severity. Sensitivity analysis was conducted in patients with severe TBI identified by receipt of intracranial pressure monitoring ortrauma craniotomy/craniectomy. Adjusted HRs (aHRs) were reported. The California Department of Health Care Access and Information Patient Discharge Dataset was queried for patients with TBI using International Classification of Diseases, Tenth Revision, Clinical Modification codes. Exclusion criteria were younger than 18 years or older than 65 years, payer other than private insurance (PI) or Medicaid, death or hospice discharge within 5 days of hospitalization, presence of a do-not-resuscitate order, and nonemergency admission. A total of 39,834 patients were analyzed (FFS, 24.2%; MCO, 33.2%; PI, 42.6%). Competing risk regressions showed that Medicaid models were associated with longer LOS compared with PI (FFS: aHR, 0.80; 95% CI, 0.80-0.83; MCO: aHR, 0.92; 95% CI, 0.87-0.96). Compared with MCOs, FFS was associated with longer LOS in the overall cohort (aHR, 0.88; 95% CI, 0.85-0.91) and in the severe TBI subgroup (aHR, 0.90; 95% CI, 0.82-0.99).”

According to the news reporters, the research concluded: “Medicaid FFS is associated with increased LOS in hospitalized patients with TBI compared with Medicaid MCOs, suggesting decreased PAC access.”

This research has been peer-reviewed.

For more information on this research see: Insurance Payer Is Associated With Length of Stay After Traumatic Brain Injury. American Journal of Managed Care, 2025;31(4). American Journal of Managed Care can be contacted at: Managed Care & Healthcare Communications Llc, 666 Plainsboro Rd, Ste 300, Plainsboro, NJ 08536, USA.

Our news journalists report that additional information may be obtained by contacting John K. Yue, University of California San Francisco (UCSF), Dept. of Neurological Surgery, 505 Parnassus Ave, M773, San Francisco, CA 94143, United States. Additional authors for this research include Nishanth Krishnan, Geoffrey T. Manley, Anthony M. Digiorgio, Christopher Toretsky, Renee Y. Hsia, W. John Boscardin and Anil N. Makam.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.37765/ajmc.2025.89688. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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