Neurobehavioral disorders: efficacy of post-hospital specialty programs

Research shows that 11-34% of patients continue with agitation following acquired neurological injury after discharge from inpatient rehabilitation.

Study objectives included 1) determining the efficacy of post hospital brain injury specialty programs, 2) determining outcomes by program type, and 3) focusing on the chronic phase of injury recovery (9-60 months post injury).

Subjects (N = 437) were selected from 854 neurologically impaired adults with consecutive discharges from post-hospital networked rehabilitation programs in 24 states from 2011 to 2021. The sample included TBI, CVA, and Mixed neurological groups with at least mild behavioral impairment measured by the Mayo Portland Adaptability Inventory-4 Irritability score. The Participation Index was used for admission and discharge comparisons.

A significant main effect from admission to discharge was found, F (1,433) = 72.90 p < 0.001, Pillai's Trace = 0.144, partial eta² = 0.144, and power to detect = 1.00. Paired sample t-tests revealed participants in the neurorehabilitation and neurobehavioral programs realized a significant reduction in disability and disruptive behavior. Supported living programs achieved similar findings.

Each group demonstrated reduced disability from admission to discharge, replicating prior research. This research provided evidence that post-hospital care provides behavioral improvement to neurologically impaired individuals.