Model systems of care for individuals with traumatic brain injury

A vast number of clinical services are needed by all persons who sustain disabling injuries. Provision of comprehensive services through a model system of care for persons with spinal cord injury has been shown to be cost effective and to favorably affect clinical outcomes. Since 1987, the National Institute on Disability and Rehabilitation Research, US Department of Education, has funded five model systems of care for persons with traumatic brain injury. Such model systems provide a coordinated continuum of care from the onset of injury when emergency medical services provide expert evacuation and transportation, followed by acute hospital medical and surgical care at a designated Level I trauma center, comprehensive inpatient and outpatient rehabilitation programs, including physical, psychological, vocational, and social services, and a long-term interdisciplinary follow-up to ensure optimal community integration. Each system also establishes programs to prevent injuries from occurring, to educate professionals and the public, and to conduct research to demonstrate system effectiveness and benefits derived from innovative interventions.