Exploring Demographic and Injury Characteristics associated with Discharging to Home after Acute Inpatient Rehabilitation

Archives of Physical Medicine and Rehabilitation(2023)

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摘要
Research Objectives Explore demographic and injury characteristics associated with discharging home after acute inpatient rehabilitation (AIR). Design Retrospective Review. Setting Acute Inpatient Rehabilitation. Participants Two thousand seven hundred fifty-two individuals with traumatic spinal cord injury (SCI), Traumatic Brain Injury (TBI), or Major Multiple Trauma (MMT) admitted to AIR from 2008-2020. Interventions N/A. Main Outcome Measures Discharge disposition (i.e., home vs. alternate setting. )Results Diagnosis specific and overall (SCI, TBI, & MMT) logistic regression models were conducted to explore factors associated with being discharged home. Race/ethnic status and sex-at-birth were not found to be significant factors associated with a discharge to home in either the overall (p>.27) or diagnosis specific (p>.068) models. The overall model found that older individuals at admission (odds ratio [OR]: 1.01, p<.01) had higher odds of being discharged to a location other than home, while individuals with greater LOS (OR: 0.98, p<.01), higher admission FIM total score (OR: 0.94, p<.01), and injuries categorized as CMG B (OR: 0.55, p<.01) were less likely to be discharged to an alternate setting (i.e., more likely to be discharged home). Age and LOS were the most consistent factors associated with discharge disposition across all models. Conclusions Disparities in AIR outcomes have been noted in the literature1–5. This study revealed several factors (LOS, FIM total, CMG B, and age) as being significant factors associated with discharge disposition. Although sex at birth or race/ethnicity were not significant factors associated with disposition status in this cohort, greater attention and work should be given to understanding long-term disparities in outcomes. Author(s) Disclosures N/A. Explore demographic and injury characteristics associated with discharging home after acute inpatient rehabilitation (AIR). Retrospective Review. Acute Inpatient Rehabilitation. Two thousand seven hundred fifty-two individuals with traumatic spinal cord injury (SCI), Traumatic Brain Injury (TBI), or Major Multiple Trauma (MMT) admitted to AIR from 2008-2020. N/A. Discharge disposition (i.e., home vs. alternate setting. Diagnosis specific and overall (SCI, TBI, & MMT) logistic regression models were conducted to explore factors associated with being discharged home. Race/ethnic status and sex-at-birth were not found to be significant factors associated with a discharge to home in either the overall (p>.27) or diagnosis specific (p>.068) models. The overall model found that older individuals at admission (odds ratio [OR]: 1.01, p<.01) had higher odds of being discharged to a location other than home, while individuals with greater LOS (OR: 0.98, p<.01), higher admission FIM total score (OR: 0.94, p<.01), and injuries categorized as CMG B (OR: 0.55, p<.01) were less likely to be discharged to an alternate setting (i.e., more likely to be discharged home). Age and LOS were the most consistent factors associated with discharge disposition across all models. Disparities in AIR outcomes have been noted in the literature1–5. This study revealed several factors (LOS, FIM total, CMG B, and age) as being significant factors associated with discharge disposition. Although sex at birth or race/ethnicity were not significant factors associated with disposition status in this cohort, greater attention and work should be given to understanding long-term disparities in outcomes.
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关键词
Spinal Cord Injury,Traumatic Brain injury,Major Multiple Trauma,Health Disparities,Acute Inpatient Rehabilitation
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