Demographic Patterns and Outcomes of Burn Center Versus Outside Center Outpatient Rehabilitation: A Burn Model System Database Study.

Abstract

Burn recovery often requires extensive outpatient rehabilitation, with physical and occupational therapy essential for improving function and reintegration. Patients may receive care at specialized burn centers or external facilities, due to influence by factors like geography and insurance. However, limited data exist on how rehabilitation settings affect patient-reported outcomes. This retrospective study reviewed adult burn survivors (2016-2024) from a multicenter longitudinal database, identifying those who reported PT/OT use in the prior six months. Rehabilitation settings were categorized as within or outside a burn center at 6, 12, and 24 months post-discharge. Demographics and usage rates were collected, and mixed-effects models (adjusted for demographics, insurance, and TBSA) assessed functional outcomes-physical function, social roles, and community integration. Of 1520 participants, 868 had data at 6 months, 679 at 12, and 496 at 24 months. PT/OT use declined over time (48.5% at 6 months, 28.6% at 12, and 18.1% at 24), with decreasing use of burn center therapy (37.5%, 31.3%, and 25.9%, respectively). Unadjusted models showed burn center rehabilitation was associated with higher physical function (+2.3) and social role scores (+2.5), but these were not statistically significant after adjustment for demographic factors. However, burn center care was significantly associated with better community integration (p=.05). Injury severity and insurance influenced care setting, but all rehabilitation settings supported recovery. While burn center rehab may enhance community reintegration, structured physical and occupational therapy, regardless of setting, benefits burn survivors' functional outcomes.