TY - JOUR
AU - A. M. Karmarkar
AU - A. Esmaeili
AU - C. E. Dismuke-Greer
AU - V. Raveendran
AU - B. Malhotra
AU - D. W. Klyce
AU - K. Kroenke
AU - J. D. Corrigan
AU - F. M. Hammond
AU - D. X. Cifu
A1 - 
AB - OBJECTIVE: To examine the association between primary care (PC) and/or polytrauma care (PTr) with health services utilization in veterans with traumatic brain injury (TBI). DESIGN: Retrospective analysis of data from the Long-term Impact of Military-Relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium Phenotype study cohort. SETTING: Veterans Health Administration. PARTICIPANTS: Veterans after the TBI-related first encounter in the Veterans Health Administration (VA) system for 4 groups: control; received only PC, but no PTr; received only PTr, but no PC; and received both PC+PTr. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Three-year utilization of subsequent emergency department, inpatient, and outpatient services. RESULTS: The cohort of veterans with TBI who received both PC and PTr had the most decline in their VA-provided health services utilization (emergency, inpatient, and outpatient). For the non-VA health services utilization, the trends were mixed and inconclusive. CONCLUSIONS: Veterans who had frontloading of both PC and PTr had the most significant decline in subsequent VA-provided health services utilization, whereas trends for non-VA health services utilization were mixed and inconclusive. To enhance care coordination and outcomes, the Veterans Health Administration could implement integrated care models that promote collaboration between PC providers and polytrauma teams. This approach may optimize resource use and improve long-term recovery and health stability for veterans with TBI.
AD - Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA; Center for Rehabilitation Science and Engineering, Virginia Commonwealth University, Richmond, VA; Clinical Science and Research Department, Sheltering Arms Institute, Richmond, VA; Central Virginia Veterans Affairs VA Health Care System, Richmond, VA. Electronic address: Amol.Karmarkar@vcuhealth.org.; Health Economics Resource Center (HERC), VA Palo Alto Health Care System, Menlo Park, CA; Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA.; Health Economics Resource Center (HERC), VA Palo Alto Health Care System, Menlo Park, CA.; Virginia Commonwealth University, School of Medicine, Richmond, VA.; Department of Art Education, Florida State University, Tallahassee, FL.; Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA; Center for Rehabilitation Science and Engineering, Virginia Commonwealth University, Richmond, VA; Clinical Science and Research Department, Sheltering Arms Institute, Richmond, VA; Central Virginia Veterans Affairs VA Health Care System, Richmond, VA.; Department of Medicine, Indiana School of Medicine, and Regenstrief Institute, Indianapolis, IN.; Department of Physical Medicine & Rehabilitation, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH.; Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, IN.
AN - 42044863
BT - Arch Phys Med Rehabil
C5 - Healthcare Disparities
DA - 04/2026
DO - 10.1016/j.apmr.2026.04.025
DP - NLM
ET - 20260425
JF - Arch Phys Med Rehabil
LA - eng
N2 - OBJECTIVE: To examine the association between primary care (PC) and/or polytrauma care (PTr) with health services utilization in veterans with traumatic brain injury (TBI). DESIGN: Retrospective analysis of data from the Long-term Impact of Military-Relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium Phenotype study cohort. SETTING: Veterans Health Administration. PARTICIPANTS: Veterans after the TBI-related first encounter in the Veterans Health Administration (VA) system for 4 groups: control; received only PC, but no PTr; received only PTr, but no PC; and received both PC+PTr. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Three-year utilization of subsequent emergency department, inpatient, and outpatient services. RESULTS: The cohort of veterans with TBI who received both PC and PTr had the most decline in their VA-provided health services utilization (emergency, inpatient, and outpatient). For the non-VA health services utilization, the trends were mixed and inconclusive. CONCLUSIONS: Veterans who had frontloading of both PC and PTr had the most significant decline in subsequent VA-provided health services utilization, whereas trends for non-VA health services utilization were mixed and inconclusive. To enhance care coordination and outcomes, the Veterans Health Administration could implement integrated care models that promote collaboration between PC providers and polytrauma teams. This approach may optimize resource use and improve long-term recovery and health stability for veterans with TBI.
PY - 2026
SN - 0003-9993
ST - Association of Polytrauma Care and Primary Care With Utilization of Health Services for Veterans With Traumatic Brain Injury
T1 - Association of Polytrauma Care and Primary Care With Utilization of Health Services for Veterans With Traumatic Brain Injury
T2 - Arch Phys Med Rehabil
TI - Association of Polytrauma Care and Primary Care With Utilization of Health Services for Veterans With Traumatic Brain Injury
U1 - Healthcare Disparities
U3 - 10.1016/j.apmr.2026.04.025
VO - 0003-9993
Y1 - 2026
ER -