Post‐Acute Care Rehabilitation after brain tumor resection: A national study of insurance claims data

Abstract

AbstractObjectiveTo assess post‐acute rehabilitation service use and length of stay among a national sample of patients with brain tumors after surgery.DesignA retrospective review was conducted of health care claims data of a national sample of patients via The Optum Clinformatics® DataMart.Setting and ParticipantsThis study included adult individuals (≥18 years of age) who were diagnosed with a brain tumor between 2015‐2019 and underwent a craniotomy or craniectomy within 180 days of diagnosis.MethodsDescriptive statistics were used to characterize patients by tumor type. Multivariate models assessed factors associated with discharge setting and length of stay.ResultsOf the 10,275 individuals identified, 69% had malignant tumors. Over two‐thirds of patients were discharged directly home (with or without home health care) while 9.3% and 9.5% were discharged to acute rehabilitation facilities (IRF) and skilled nursing facilities (SNF/ICF), respectively. About 13.5% were discharged to other settings. The average length of stay during the episode of care was 8.6 (SD=9.6) days. After adjusting for confounders, individuals with benign brain tumors were more likely to be discharged to either IRF or SNF/ICF than return home after acute care stay, as were those with greater comorbidities, older age, fee‐for service and HMO insurance. Wealthier patients were less likely to be discharged to a SNF/ICF than home, although income was not a factor affecting discharge to an IRF. Patients with benign tumors, the oldest old (80+), those with more comorbidities as well as Black and Hispanic patients had a longer length of stay during the acute hospitalization.Conclusions and ImplicationsIndividuals with brain tumors have deficits amenable to rehabilitation; however, our study finds that service use differs by tumor type, demographic and socioeconomic factors. Further study is needed to identify if there are barriers to access and use of rehabilitation services in this population.This article is protected by copyright. All rights reserved.