Original researchRegional Variations in Rehabilitation Outcomes of Adult Patients With Traumatic Brain Injury: A Uniform Data System for Medical Rehabilitation Investigation
Section snippets
Study design
We conducted a secondary analysis of a national, observational, multicenter dataset. Findings are reported in accordance with STROBE guidelines.23
Data source
Data were drawn from the Uniform Data System for Medical Rehabilitation (UDSMR),24,25 which contains a national sample of all conditions requiring IRF care. For this study, we used data on adult TBI patients who received IRF care. The UDSMR collects data from more than 70% of the IRFs in the US and contains patient-level rehabilitation and
Patient and clinical characteristics
The final sample included 175,358 TBI patients admitted for IRF care. The sample was 63.3% men and had a median age of 67 years (interquartile range [IQR], 45-80y). The sample was 78.5% white, 7.9% Black, 2.4% Asian, 0.7% Native American, 0.6% Pacific Islander, and 10% other. Approximately 7.5% of the sample identified as Hispanic or Latino. The marital status category with the largest percentage was “married” (43.9%).
Patients had a median total FIM score of 46 (IQR, 30-63) at admission, which
Discussion
The purpose of this study was to examine regional differences in outcomes of TBI patients who received IRF care, including discharge functional status, LOS, and discharge home. Findings showed that patient and clinical characteristics varied significantly by geographic location, as did functional status, LOS, and percentage of patients discharged home. Also, IRF region, race and ethnicity, age, number of falls during IRF stay, and insurance status were associated with discharge functional
Conclusion
Our findings show evidence of differences in regional outcomes and potential disparities in care for TBI patients. These findings should be further explored to identify the root causes of disparities in care and improve outcomes for TBI patients who receive IRF care.
Supplier
- a.
R, version 3.5.2; The R Project for Statistical Computing.
Acknowledgments
We thank the Emory University Department of Emergency Medicine, the Injury Prevention Research Center at Emory, and Duke University faculty and staff for guidance with manuscript revision. The data for this study were obtained and used with permission from the Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activities, Inc. We thank Uniform Data System for Medical Rehabilitation for providing access to the data.
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Supported by internal funds from the Emory University School of Medicine Department of Emergency Medicine.
Disclosures: none.