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Distinguishing Characteristics of Admissions to Various Types of Posthospital Brain Injury Rehabilitation Programs
David B Salisbury1, Devan Parrott, Irwin M Altman
1Author Affiliations: Pate NeuroRehabilitation/Rehab Without Walls, Irving, TX (Dr Salisbury); Foundation to Advance Brain Rehabilitation (FABR) (Dr Parrott and Dr Malec); Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, IN (Dr Parrott and Dr Malec); Collage Rehabilitation Partners, Paoli, PA (Dr Altman); ReMed Recovery Care Centers, Paoli, PA (Ms Eicher); On With Life, Ankeny, IA (Mr Logan and Mr Walters), Bancroft NeuroRehab, Cherry Hill, NJ (Dr McGrath), Mayo Clinic, Rochester, MN (Dr Malec).
Objective:
Describe and compare the demographic characteristics and disability profiles of individuals admitted to 6 types of posthospital brain injury rehabilitation (PHBIR) programs.
Setting:
Data from Residential Neurobehavioral, Residential Neurorehabilitation, Home and Community Neurorehabilitation, Day Treatment, Outpatient Neurorehabilitation, and Supported Living programs serving individuals with acquired brain injury (ABI).
Participants:
Two thousand twenty-eight individuals with traumatic brain injury (TBI), stroke, or other ABI.
Main Measures:
Sex, age, time since injury, and Mayo-Portland Adaptability Inventory, 4th edition (MPAI-4).
Design:
Retrospective analyses of demographic variables and MPAI-4 Total, Index, and subscale Rasch-derived T-scores on admission comparing diagnostic categories and program types within diagnostic categories.
Results:
Participants with TBI were predominantly male, and those with stroke were generally older. Admissions to more intensive and supervised programs (residential neurobehavioral and residential neurorehabilitation) generally showed greater disability than admissions to home and community programs who were more disabled than participants in day treatment and outpatient programs. Residential neurobehavioral and supported living program participants generally were male and had TBI. Home and community admissions tended to be more delayed than residential neurorehabilitation admissions. The majority of those with other ABI were admitted to outpatient rather than more intensive programs. Additional analyses demonstrated significant differences in MPAI-4 profiles among the various program types.
Conclusions:
Admissions with TBI, stroke, and other ABI to PHBIR differ in demographic factors and disability profiles. When examined within each diagnostic category, demographic features and disability profiles also distinguish among admissions to the various program types. Results provide insights about decision-making in referral patterns to various types of PHBIR programs, although other factors not available for analysis (eg, participant/family preference, program, and funding availability) likely also contribute to admission patterns.
