WHODAS 2.0 Can Predict Institutionalization among Patients with Traumatic Brain Injury

Shih-Wei Huang, Kwang-Hwa Chang, Reuben Escorpizo, Feng-Hang Chang and Tsan-Hon Liou
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Shih-Wei Huang: Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei 23561, Taiwan
Kwang-Hwa Chang: Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
Reuben Escorpizo: Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, University of Vermont, Burlington, VT 05401, USA
Feng-Hang Chang: Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
Tsan-Hon Liou: Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei 23561, Taiwan

IJERPH, 2019, vol. 16, issue 9, 1-9

Abstract: Patients with traumatic brain injury (TBI) often present with disabilities associated with a high burden of care for caregivers or family members at home. When family members cannot afford to care for patients with TBI, they are often required to find them residence in long-term care institutions. To date, there are no quantitative assessment tools developed to predict institutionalization. Therefore, this study analyzed the accuracy of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) for predicting the institutionalization of patients with TBI. We designed a cross-sectional study using a nationwide disability database. We analyzed the data of 8630 patients with TBI with injury for more than six months from the Taiwan Data Bank of Persons with Disability during July 2012–October 2018. The demographic data and WHODAS 2.0 standardized scores of patients with TBI who resided in community and long-term care institutions were analyzed. Receiver operating characteristic curve (ROC) analysis was performed to investigate the predictive accuracy of WHODAS 2.0 for being institutionalized, and the optimal cut-off point was determined using the Youden index. Binary logistic regression was employed to determine the predictors of the participants being institutionalized. The WHODAS 2.0 scores in each domain were lower in the community group than in the institutionalized group. ROC analysis revealed the highest accuracy for the summary scores of WHODAS 2.0 (area under the curve = 0.769). Binary logistic regression revealed that age, gender, work status, urbanization level, socioeconomic status, severity of impairment, and WHODAS 2.0 domain scores were factors associated with the institutionalization status of patients with TBI. Our results suggest that WHODAS 2.0 may be a feasible assessment tool for predicting the institutionalization of patients with TBI.

Keywords: traumatic brain injury (TBI); institutionalization; predictor; International Classification of Functioning, Disability, and Health; Taiwan; World Health Organization Disability Assessment Schedule 2.0 (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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