Regional Variations in Rehabilitation Outcomes of Adult Patients With Traumatic Brain Injury: A Uniform Data System for Medical Rehabilitation Investigation.
Tolu O Oyesanya, Tim P Moran, Tamara R Espinoza and 1 others
PMID 32861669WHAT IT FOUND
Adults with traumatic brain injury discharged after inpatient rehabilitation varied widely by U.S. region.
After accounting for patient factors, some regions had higher discharge function scores, longer stays, or lower likelihood of going home.
Key findings
01Median length of stay ranged from 14 days in Regions 5 and 10 to 17 days in Region 1.
02After adjustment, Regions 3, 6, 7, and 8 were associated with greater total discharge FIM scores than Region 4, while Regions 2, 5, and 9 were associated with lower scores.
03Discharge to home was least likely in Region 1 at 48.8% and most likely in Region 10 at 71.9%, and in adjusted analyses patients in all other regions were less likely to be discharged home than Region 4.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The regions were based on the location of the facility, not the patient's residence. The dataset does not include all U.S. inpatient rehabilitation facilities, so the findings may not represent every facility. The dataset lacks details on rehabilitation treatment, injury severity, hospital procedures, and treatment before admission. Functional Independence Measure data were entered by individual facilities, so accuracy may vary. The observational design can show associations, not causation.
Declared interests
No author conflicts of interest or funding declaration appears in the supplied text. The publication metadata lists non-U.S. government research support.
The easy way to misread this
Do not conclude that choosing a facility in a better performing region will improve outcomes. The study reports associations in registry data and lacks details on treatment intensity, injury severity, and care processes, so it cannot show that region caused the differences.