The Yin and Yang of Integrated Care: Systemic Imperatives for Traumatic Brain Injuries

Traumatic brain injuries remain a 21 century scourge that remains subterranean and mostly invisible in our societies. Integrated care systems for traumatic brain injury patients effectively integrate the key systemic components horizontally and vertically so as to improve patient outcomes and systemic performance. This review paper briefly identifies the nature of traumatic brain injuries in Canada and the European Union. Internationally, there is a wide spectrum of health care systems and supporting infrastructures that reflect a very diverse and complex range of societal values, political ideologies, and states of economic and social development. As a consequence, each nation or political entity will have a different response or ability to respond to traumatic brain injuries. The manuscript underscores the need to recognize traumatic brain injuries as a universal public health challenge and briefly identifies the systemic components of care in Canada and the European Union that are sociopolitical entities that have a blend of both government-directed and marketeconomies. The paper posits that there are four evolving systemic imperatives that should be considered in providing effective care to the traumatic brain injury patients for the 21 century. These include: integrated care planning; integrated information systems; virtualized continuity of care and health leadership imperatives. How each socioeconomic entity integrates these building blocks will vary, as will the effectiveness to these types of injuries. The paper concludes with a brief discussion of public health choices that lie at the heart of the scourge of traumatic brain injuries.