Paul M. Deutsch Ph.D.’s scientific contributions

This retrospective cohort study examined the vocational outcomes in forty-four traumatically brain injured patients. Patient files selected were limited to those who were seen for the development of an original Life Care Plan and were subsequently seen at least once for a complete update of that plan. Patients who were retired at the time of the brain injury were excluded. Each participant was actively involved in litigation at the time of the initial evaluation as well as at the time of his or her update evaluation. Traumatic brain injury resulted from various etiologies. Vocational outcomes were analyzed in relation to severity of injury, age at onset, gender and education. Vocational outcome was reported as a return to work, supported employment, return to school or training or permanent total disability. Twenty-one patients were classified as permanent-total disabilities. Twenty-three returned to work, supported employment, or were successfully in school and expected to return to work. This 52% rate of vocational or school participation is particularly noteworthy since all cases were actively in litigation. A significant trend was found for severity of injury, and level of education, but not for age at onset or gender. These factors are discussed in relation to the subjects' participation in third party civil litigation and implications for Life Care Planning.

Abstract: This study examines the impact of two types of technology, new and replacement, on life care plans (LCPs) over time. Seven categories of the LCP are evaluated across an average fifteen year time span, Era I versus Era II. The Foundation for Life Care Planning Research provided access to LCPs in their database for this study. A total of fifty LCPs written for children diagnosed with cerebral palsy are analyzed in a retrospective cohort study comparing costs projections from two time eras. Era I plans originated between 1986 and 1991, while Era II plans originated between 2002 and 2004. These seven categories of the LCPs are examined: Wheelchair Needs, Orthotics/Prosthetics, Home Furnishings and Accessories, Aids for Independent Function, Medications, Supplies and Future Medical Care - Aggressive Treatment. Research results indicate either new or replacement technology had a significant impact on LCP costs projections in the categories of Wheelchair Needs, Home Furnishings and Accessories, Medications, Supplies and Future Medical Care - Aggressive Treatment between Era I and Era II. Only Orthotics/Prosthetics and Aids for Independent Function did not show a statistically significant difference between Era I and Era II. Suggestions for additional research and the development of an approach for including the impact of technology on LCP costs projections will be discussed.