Health care utilization by persons with chronic disabilities who have been vocationally rehabilitated

This investigation focuses on the effect of vocational rehabilitation on persons with chronic disabilities who have epilepsy, heart disease, spinal cord injury, arthritis, or emphysema. A thesis is proposed that such rehabilitants might be more vulnerable to unemployment than others, and it is also hypothesized that this frequently would be related to health care utilization. The study comprised 338 former clients of the State Rehabilitation Agency who had their cases successfully closed in the two-year period immediately prior to this study. All persons were sent a 12-page questionnaire dealing with matters of health, employment, social support, demography, medical economics, expressed needs, and relationship with the rehabilitation agency. Two-thirds (N = 213) of the clients responded. In addition, supplemental information was volunteered substantially by narrative and telephone. The primary thesis of the project was sustained; 43.7% were either unemployed or working less than full time six months after rehabilitation. However, few of the respondents reported having difficulties with health care utilization or availability. We propose a different rehabilitation services model to meet the needs of such clients. It should accentuate better diagnosis, careful selection of objectives, adequate vocational preparation, health care advisement, and more extensive job follow-up.