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3rd International Conference on
Health Care and
Health Management
Joint Event
&
November 04-05, 2019 | Prague, Czech Republic
6th International Conference on
Neuroscience and
Neurological Disorders
Journal of Neurology and Clinical Neuroscience | Volume 3
Beyond diagnosis: A longitudinal, case control study predicting use of casemanagement
services for adolescents and adults living in community following brain injury, with
implications for long-term support access
Barbara Baptiste
Rehabilitation Sciences Institute (RSI), Canada
Statement of the Problem: Individuals diagnosed with brain
injury (BI) experience a myriad of functional limitations
throughout their lifespan. CaseManagement (CM) is a service
that assists in coordinating care to ensure access and use of
services to address both activity and participation limitations.
These functional changes range fromphysical to cognitive and
include mental health challenges. The impact on individuals,
families and society is substantial. After diagnosis, the first
question individuals and families will ask the physicians is on
prognosis (their future). What will the future bring? How will
I function? Can I work? Will I experience a downward spiral
at some point? CM has been identified as a support service
to assist people through the maze of lifelong changes. This
research used a published model for service use to analyze
a province-wide, longitudinal database of persons with BI,
which included questions on service use. A case-control
design was used to compare users and non-users of the CM
service. CM use was considered a primary access point for
other services in the community. The study sample came
from questionnaires of 203 users of CM services and 273
non-users, complete for all outcome and predictor variables.
These were individuals with BI, 15 years of age and older. Out
of a dataset of 1,960 questionnaires, 476 met the inclusion
criteria. There were eight predictor variables and one
outcome variable (use or non-use of the service). Predictor
variables considered the framework of the Behaviour Model
of Health Service Use (BMHSU); specifically, pre-disposing,
need and enabling factor groups as these relate to health
outcomes and service use and access. Analyses revealed
significant differences between users and non-users of CM
services. In particular, users were significantly younger than
non-users as the older the person the less likely to use the
service. Also, users had less education and more severe
activity limitations and lower community integration. Persons
living alone are less likely to use case management. Funding
groups also significantly impact users. Implications exist for
future care need and service use and access, following BI and
other neurotraumas and health conditions.
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