Inpatient rehabilitation after acute injury or illness for patients with and without mental health disorders: service utilization, functional improvement, and pain.

Abstract

Objective: Compare rehabilitation process and outcomes between patients with and without mental health disorders.

Design: Observational cohort study.

Subjects: 130 patients receiving post-acute inpatient rehabilitation after acute injury or illness.

Methods: Mental health disorders were assessed with diagnostic interviews. Adjusted regression analysis examined associations between mental health disorders and rehabilitation processes, func-tional improvement, pain, and patient satisfaction.

Results: Patients with mental health disorders had more psychologist sessions (B = 5.87, 95% CI 3.87-7.87), more cancelled physiotherapy sessions (B = 1.15, 95% CI 0.38-1.93), multiprofessional team members collaborated more with external partners (B = 6.10, 95% CI 2.88-9.32), and nurses and team coordinators found their roles more demanding (OR = 5.47, 95% CI 1.38-21.76; OR = 7.43, 95% CI 2.21-24.94). Mental health disorders were associated with higher pain intensity and pain interference (B = 1.25, 95% CI 0.38-2.12; OR = 6.81, 95% CI 1.39-33.30). Opioid use was comparable on admission, but the mental health disorder group used more on discharge (OR = 4.5, 95% CI 1.75-11.55). Change in functional independence and patient satisfaction was comparable.

Conclusion: Comorbid mental health disorders were associated with several aspects of the post-acute rehabilitation process, including resource use and pain management. These findings may inform the planning and organization of rehabilitation services for patients with mental health challenges.