Disparities in Postacute Care Utilization for Individuals with Traumatic Brain Injury 8255

IF 3.6 2区医学 Q1 REHABILITATION

Archives of physical medicine and rehabilitation Pub Date : 2025-04-01 DOI:10.1016/j.apmr.2025.01.054

Amol Karmarkar, Alexandra Ulbing, Amit Kumar

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引用次数: 0

Abstract

Objectives

To examine disparities in postacute care transitions across inpatient rehabilitation facility, skilled nursing facility, and home health care in individuals with traumatic brain injury.

Design

Secondary analysis of All-Payer Claims Data (2017-2021) from Virginia. We linked the individual-level data, with provider- and region-level data.

Setting

Acute hospitals and postacute settings in Virginia.

Participants

Patients with traumatic brain injury discharged to inpatient rehabilitation facility, skilled nursing facility, or home health care (N=8662).

Interventions

None.

Main Outcome Measures

Postacute settings, adjusting for patient-level covariates (sociodemographic characteristics, type of insurance, acute length of stay, Elixhauser comorbidity index, hospital-acquired complications), and region-level covariates (postacute availability, county ranking, and population). We constructed hierarchical generalized linear mixed models and Blinder-Oaxaca models for decomposing race and region effects.

Results

Approximately, 35% of our sample population did not receive any postacute care after hospitalization. For Hispanics and others, this rate was 46%. There were differences by race/ethnicity in types of postacute care settings. We also found variation in use of postacute care by region.

Conclusions

In the era of value-based payment models, it is important to examine long-term outcomes associated with postacute care transitions and develop care coordination models to eliminate disparities in access of postacute rehabilitation care.

Supported by the Commonwealth Neurotrauma Initiative (CNI): Transitions and Disparities in Care and Outcomes (TDCO) for Neurotrauma (Award # A262-90012).

Disclosures

none.

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来源期刊

Archives of physical medicine and rehabilitation 医学-康复医学

CiteScore

6.20

自引率

4.70%

发文量

495

审稿时长

38 days

期刊介绍： The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities. Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.