Equity in Access to Outpatient Rehabilitation Services For Children With Traumatic Brain Injury and Public Insurance
Section snippets
Research Objectives
Identify insurance-based disparities in access to outpatient rehabilitation services for children.
Design
Audit study using paired telephone calls by callers posing as mother of a child with history of severe TBI seeking outpatient rehabilitation services.
Setting
Outpatient rehabilitation service clinics in Washington State.
Participants
195 Physical Therapy (PT), 109 Occupational Therapy (OT), 102 Speech Therapy (ST) and 11 Rehabilitation Medicine clinics.
Interventions
Not applicable.
Main Outcome Measure(s)
Offer of appointment at clinic and wait time in work days until the next available appointment.
Results
Therapy clinics were more likely to accept private versus public insurance (relative risk (RR) for PT 1.33 (95% confidence interval (CI) 1.22-1.44), for OT 1.40 (95% CI 1.24-1.57), and for ST 1.42 (95% CI 1.25-1.62)), but there was no significant difference for Rehabilitation Medicine clinics (RR 1.10, 95% CI 0.90-1.34). The difference in median wait time between clinics that accepted public versus only private insurance was 4 business days for PT and 15 days for PT (p ≤ .001) but not
Conclusions
There are insurance-based disparities in access to outpatient rehabilitation services. Therapy clinics offering services for children with TBI were less likely to offer appointments for callers with public versus private insurance. Therapy clinics accepting public insurance had longer wait times than clinics that accepted only private insurance.
Key Words
Health Services Accessibility, Rehabilitation Centers, Healthcare Disparities, Disabled Children
Disclosures
None disclosed.