Table 3.

Disparities studies

Study Title	Study Author(s)/Year	Findings	Type of Utilization/Cost
Impact of socioethnic factors on outcomes following traumatic brain injury.	Heffernan et al., 2011	In a Level 1 trauma ED population, private insurance associated with shorter length of stay and intoxication with longer length of stay. Non-Caucasian race and lack of insurance associated with lower likelihood of placement in rehabilitation.	Length of stay, emergency department and rehabilaition utilization in TBI.
The effect of insurance status, race, and gender on ED disposition of persons with traumatic brain injury.	Selassie et al., 2004	In a state of SC hospital ED population, after adjusting for demographic, clinical and hospital characteristics, uninsured and black females had lower likelihood of hospitalization	Emergency department and hospitalization utilization in TBI.
Ethnic and racial disparities in emergency department care for mild traumatic brain injury	Bazarian et al., 2003	In a national sample of ED visits, after controlling for confounders, Hispanics more likely to receive nasogastric tube, nonwhites more likely to receive care by a resident and less likely to be sent back to a referring physician after ED discharge	Nasogastric tube and physician utilization in TBI.
Does Health Care Insurance Affect Outcomes After Traumatic Brain Injury?	Alban et al., 2010	Insured patients had longer ICU stay in unadjusted analysis.	ICU utilization in TBI.
Traumatic Brain Injury Hospitalizations Among American Indians/Alaska Natives	Rutland-Brown W. et al., 2005	Among 182,130 individuals hospitalized with TBI in 13 states, American Indians and Alaskan Natives (AI/AN) had the highest age adjusted rates of hospitalization for TBI relative to other race/ethnicities. The greatest difference occurred for individuals between 20 and 44 years old. High blood alcohol levels and low use of vehicle restraints were more prevalent in AI/AN.	Hospital utilization in TBI.
Measuring Unmet Needs and Services Among Persons with Traumatic Brain Injury	Heinemann et al., 2002	Most prevalent unmet needs were for memory (50.5%) job skills (46.3%), increasing income (50.5%). Black, younger and single individuals as well as those dependent in one or more daily activities and with more recent injuries had greater unmet needs.	Unmet Needs in TBI
The Use of Medicaid Waivers and their Impact on Services	Spearman RC et al., 2001	A review of TBI Medicaid Waivers in six states allowing flexibility in care and design of integrated service plans for those with TBI showed that the ability to obtain a waiver was associated with social-medical-political climate, similarity to other waivers, ability to strengthen access and reduce barriers, and expenditure of resources. Managing waivers was associated with cost effectiveness, developmental process of waiver implementation, ability to improve access and reduce barriers, and expenditure of resources.	Medicaid Waiver Utilization in TBI.
National estimates of hospitalization charges for the acute care of traumatic brain injuries	Schootman M. et al., 2003	Mean and median acute care charges were only slightly higher for males compared with females however the median age increased with age until age 34 after which it remained stable. Mean and median charge increased with increasing injury severity. Mean and median charges were highest for the western region of the US and for persons covered by Medicaid and those treated at urban teaching hospitals.	Inpatient hospital charges in TBI.
Is There Equity in Long-Term Healthcare Utilization After Traumatic Brain Injury?	Willemse-van Son MA 2009	Among 79 patients with moderate/severe TBI in Netherlands, those with a high locus of control with the physician were more likely to visit medical specialists and use supportive care than those with lower levels of internal locus of control.	Physician and supportive care utilization in TBI in Netherlands.
Sixteen years on: Has quality of care for rural and non-compensable traumatic brain injury clients improved	O’Callaghan et al., 2009	Rural TBI patients more likely to be treated in non-inpatient setting than urban TBI patients in Australia though no significant difference in functional outcome.	Non-inpatient utilization in TBI in Australia.
Rehabilitation Outcomes of Terror Victims with Multiple Traumas	Schwartz et al., 2008	Terror victims with TBI had higher rates of brain surgery but no difference in length of stay in hospital relative to non-terror victims in Israel.	Surgical utilization in TBI in Israel.