Umeå University's logo

Background: Individuals with more education com-monly have better outcome after brain injury, often attributed to cognitive reserve. However, evidence suggests that individuals with more education have better access to specialized care, potentially affec-ting outcomes.

Objective: To investigate differences in healthcare usage based on cognitive reserve and examine the relationship between healthcare usage and outcomes after stroke and traumatic brain injury.

Design: An observational cohort study with health-care usage data from 3 years before to 4 years after injury, interviewing patients 5–15 years after injury. Patients: A total of 83 participants suffering a stroke or traumatic brain injury.

Results: Healthcare usage over time varied based on educational level (repeated measures ANOVA, F(2, 227) = 4.17, p = 0.008). The differences in healthcare usage between educational levels was significant during the injury year (F(81) = –5.47, p = 0.022). Higher education implied more healthcare usage. Linear regression, controlling for possible confoun-ders, confirmed the relationship between education and healthcare usage, (β = 4.3, p = 0.022). Health-care usage was significantly related to long-term life satisfaction, but not to return to work.

Conclusion: Individuals with more education recei-ved more healthcare in the year after traumatic brain injury or stroke. However, this was not related to long-term outcome regarding return to work, but we found a relationship between healthcare usage and life satisfaction.