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Medical and Rehabilitation Service Use After Inpatient Rehabilitation

Categories: Recovery - Long Term

The Question

What medical and rehabilitation services do individuals with brain injury use during the first three months after being discharged from inpatient rehabilitation?

Past Studies

Past Studies show that it is common for individuals with traumatic brain injury to require medical and therapy services after completing their inpatient rehabilitation programs. Researchers have found that continuing rehabilitation after the inpatient stay can be helpful for some individuals. Service settings for post-acute rehabilitation options vary and can include day programs, nursing homes, transitional housing, home health-care, and outpatient services. Many factors can affect the services that individuals with brain injuries receive after completing inpatient rehabilitation. There does not appear to be “one set path to take,” but rather, service participation can be limited by an individual’s insurance coverage, costs, service availability and typical practice in a local area, injury severity, and the preferences of the individuals and their families. Researchers have not fully examined what types of services are used the most and how much of the services are utilized.

This Study

This study tracked the services used by 73 individuals for the first three months after they left the inpatient rehabilitation setting. The individuals had sustained mild, moderate, or severe traumatic brain injuries. The researchers surveyed the individuals or their participating family members at one and three months after their discharge dates from inpatient rehabilitation.

The researchers found that at least 80% of the participants saw a doctor during the three-month study period. Forty-two percent had four or more doctor visits. The researchers found that more than half of the participants participated in full-day or half-day hospital day rehabilitation programs. The participants were more likely to participate in rehabilitation in outpatient settings than with in-home therapies. Individuals with mild brain injuries spent fewer days in in-hospital day rehabilitation programs but were just as likely to use services as those with moderate or severe brain injuries. Individuals with severe brain injuries were more likely to receive outpatient physical therapy. Those with moderate brain injuries used the most outpatient occupational therapy and speech-language pathology services. Participants with mild brain injuries tended to use the most nontraditional therapies, such as vocational rehabilitation. Nontraditional therapies were used less often and by fewer people than traditional therapies.

Who May Be Affected By These Findings

Individuals with traumatic brain injuries, healthcare providers, funders, and researchers

Caveats

Contrary to past studies, the severity of the initial traumatic brain injury was not associated with the likelihood of service use after inpatient rehabilitation. Individuals with mild, moderate, and severe brain injuries were just as likely to use outpatient services.

Bottom Line

At least 80% of the participants saw a doctor during the three-month study period and more than half of the participants participated in full-day or half-day hospital rehabilitation programs. Individuals with mild brain injuries spent fewer days in day rehabilitation programs but were just as likely to use services as those with moderate or severe brain injuries.

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Find This Study

Phillips, V.L., Greenspan, A.I., Stringer, A.Y., Stroble, A.K., & Lebtonen, S. (2004). Severity of injury and service utilization following traumatic brain injury: The first three months. Journal of Head Trauma Rehabilitation, 19, 217-225.

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