Traumatic brain injury (TBI) can result in substantial healthcare costs
and permanent disabilities. Effective treatments are available, but these
treatments are often only available to those who live in or near a metropolitan
area. Inevitably, there will be differences between children who survive
a TBI living in either a rural or an urban area.
A recent study in Oregon found that the rate of TBI in rural areas is significantly
higher than in urban areas, possibly because of differences in risk factors
as related to physical environments and socioeconomic status. Children
who were treated for a TBI within a rural area are more than twice as
likely to die as a result of the injury than children treated for TBI
within an urban area—even after controlling for age, gender, race,
insurance status, and injury severity.
There may be substantial differences in the care and treatment of children
in rural areas that affects this increased rate of mortality. Transportation
distance may have some effect, but the study found that less experienced
medical workers and a low retention rate were more likely to negatively
affect mortality rate in rural areas.