Civilian Stakeholder Perspectives on the Facilitators and Barriers to Meeting the Needs of Persons with TBI

Research Objectives: To assess the facilitators and barriers of healthcare needs of persons with traumatic brain injury (TBI) across healthcare systems.

Design: The study utilized an access to health care framework, to guide the development of qualitative research on stakeholders’ perceptions of the facilitators and barriers to accessing care for individuals with brain injury.

Setting: Research activities were conducted virtually through Microsoft Teams.

Participants: Participants were from state and national level brain injury organizations.

Interventions: No intervention was utilized.

Main Outcome Measures: Demographic survey and semi-structured qualitative interviews and focus groups.

Results: Civilian stakeholders reported perceived facilitators and barriers to accessing care for individuals with brain injury. Perceived facilitators included resource facilitation provided by brain injury organizations, utilization of organizational partnerships, and utilization of telehealth to increase engagement and reduce barriers. Perceived barriers included understaffed service systems, transportation, access to case management services, appropriate long-term care facilities, housing insecurity, inadequate insurance coverage allowances, and meeting eligibility criteria regarding state-level resources. Stakeholders also reported admiration for the ability of VA healthcare systems to provide comprehensive multidisciplinary care compared to fragmented civilian healthcare systems.

Conclusions: Findings from this study highlighted strengths within the civilian healthcare system including organizational partnerships, telehealth, and resources such as the brain injury associations and alliances. The barriers such as transportation, housing, case management, and insurance are consistent with prior research. Challenges identified related to community-based care can inform the VA healthcare system on ways to improve services available to Veterans. These findings provide insight into ways to improve the civilian healthcare system.

Author(s) Disclosures: The authors have no disclosures to report. The views expressed in this abstract are those of the authors and do not necessarily represent the official policy or position of the Defense Health Agency, Department of Defense, or any other U.S. government agency. For more information, please contact dha.TBICOEinfo@health.mil.