Subsequent Emergency Department Visits in Geriatric Mild Traumatic Brain Injury: Relationship with Fall, Payor, and Discharge Outcome

Background/Objectives: Older adults (ages ≥ 65) have experienced longer recovery, decreased independence in self-care, and reduced quality of life after diagnosis of mild traumatic brain injury (mTBI). Although the sequela following mTBI has also generated higher healthcare costs in older adults, the research on associations returning to the emergency department (ED) has been limited. This study explored subsequent mild traumatic brain injury (mTBI-S) ED visit relationships among older adult populations, fall injuries, payors, and discharge outcomes. Methods: The design was a population-based cross-sectional study using data from the 2018 Nationwide Emergency Department Sample (NEDS). The study sample size was 4932. Descriptive analysis and correlation analysis described characteristics of people with subsequent mTBI visits. Logistic regressions and odds ratios ascertained the relationship between subsequent mTBI visits and the predictor variables of age, fall injury, payors (Medicare, Medicaid, Private, and other), and the outcome variable of healthcare services. Results: Falls and referrals to healthcare service associations were significant (p < 0.001, X²₁ = 123.6). The association between Medicare and referral to healthcare service visits was also significant (p < 0.001, X²₃ = 1059.9). The odds ratio in populations aged ≥ 65 (OR 4.172, p < 0.001, CI 95% 3.427, 5.079), falls (OR 3.847, p < 0.001, CI 95% 2.649, 5.587), and Medicare (OR 4.492, p < 0.001, CI 95% 1.273, 2.106) had an increased probability of referral to healthcare services. Conclusions: Geriatric populations, falls, and Medicare carriers had an increased probability of healthcare service referral upon readmission to the ED for persistent symptoms after mTBI. Research on geriatric populations and post-mTBI medical monitoring may inform ED discharge models.