Institutional Variation in Traumatic Brain Injury Acute Rehabilitation Practice.

MedStar author(s):
Citation: Archives of Physical Medicine & Rehabilitation. 96(8 Suppl):S197-208, 2015 Aug.PMID: 26212397Institution: MedStar National Rehabilitation NetworkForm of publication: Journal ArticleMedline article type(s): Journal Article | Multicenter Study | Research Support, N.I.H., Extramural | Research Support, U.S. Gov't, Non-P.H.S.Subject headings: *Brain Injuries/rh [Rehabilitation] | *Institutional Practice/sn [Statistics & Numerical Data] | Aged | Canada | Female | Humans | Length of Stay | Male | Occupational Therapy | Physical Therapy Modalities | Population Surveillance | Prospective Studies | Recreation Therapy | Speech Therapy | Treatment Outcome | United StatesLocal holdings: Available online from MWHC library: 2000 - present, Available in print through MWHC library:1999-2007ISSN:
  • 0003-9993
Name of journal: Archives of physical medicine and rehabilitationAbstract: CONCLUSIONS: This study provides preliminary evidence that there is significant institutional variation in rehabilitation practice and that center effects play a stronger role than patient factors in determining how TBI inpatient rehabilitation is delivered.Copyright � 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.DESIGN: Secondary analysis of a prospective, multicenter, cohort database.INTERVENTIONS: Not applicable.MAIN OUTCOME MEASURES: Mean minutes; number of treatment activities; use of groups in occupational therapy, physical therapy, speech therapy, therapeutic recreation, and psychology inpatient rehabilitation sessions; and weekly hours of treatment.OBJECTIVE: To describe institutional variation in traumatic brain injury (TBI) inpatient rehabilitation program characteristics and evaluate to what extent patient factors and center effects explain how TBI inpatient rehabilitation services are delivered.PARTICIPANTS: Patients with complicated mild, moderate, or severe TBI (N=2130).RESULTS: A wide variation was observed between the 10 TBI programs, including census size, referral flow, payer mix, number of dedicated beds, clinician experience, and patient characteristics. At the centers with the longest weekday therapy sessions, the average session durations were 41.5 to 52.2 minutes. At centers with the shortest weekday sessions, the average session durations were approximately 30 minutes. The centers with the highest mean total weekday hours of occupational, physical, and speech therapies delivered twice as much therapy as the lowest center. Ordinary least-squares regression modeling found that center effects explained substantially more variance than patient factors for duration of therapy sessions, number of activities administered per session, use of group therapy, and amount of psychological services provided.SETTING: TBI inpatient rehabilitation programs.All authors: Barrett RS, Beaulieu CL, Corrigan JD, Cullen N, Garmoe W, Hammond FM, Horn SD, Ryser DK, Seel RT, Sommerfeld TDigital Object Identifier: Date added to catalog: 2016-01-13
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article Available 26212397

Available online from MWHC library: 2000 - present, Available in print through MWHC library:1999-2007

CONCLUSIONS: This study provides preliminary evidence that there is significant institutional variation in rehabilitation practice and that center effects play a stronger role than patient factors in determining how TBI inpatient rehabilitation is delivered.Copyright � 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

DESIGN: Secondary analysis of a prospective, multicenter, cohort database.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Mean minutes; number of treatment activities; use of groups in occupational therapy, physical therapy, speech therapy, therapeutic recreation, and psychology inpatient rehabilitation sessions; and weekly hours of treatment.

OBJECTIVE: To describe institutional variation in traumatic brain injury (TBI) inpatient rehabilitation program characteristics and evaluate to what extent patient factors and center effects explain how TBI inpatient rehabilitation services are delivered.

PARTICIPANTS: Patients with complicated mild, moderate, or severe TBI (N=2130).

RESULTS: A wide variation was observed between the 10 TBI programs, including census size, referral flow, payer mix, number of dedicated beds, clinician experience, and patient characteristics. At the centers with the longest weekday therapy sessions, the average session durations were 41.5 to 52.2 minutes. At centers with the shortest weekday sessions, the average session durations were approximately 30 minutes. The centers with the highest mean total weekday hours of occupational, physical, and speech therapies delivered twice as much therapy as the lowest center. Ordinary least-squares regression modeling found that center effects explained substantially more variance than patient factors for duration of therapy sessions, number of activities administered per session, use of group therapy, and amount of psychological services provided.

SETTING: TBI inpatient rehabilitation programs.

English

Powered by Koha