Understanding Problems in Communication and Cognition Experienced by Uninsured Individuals Following Brain and Spinal Cord Injuries.

Purpose: Uninsured individuals who experience brain injury and spinal cord injury (SCI) may not have access to health care services following their injury. We describe the demographic characteristics and reported problems in communication and cognition of individuals attending the Georgia Rehabilitation Services Volunteer Partnership (RSVP) Clinic, a free clinic that provides rehabilitative care to uninsured and underinsured individuals who experience these injuries.

Method: Descriptive statistics examined at admission include injury type, age, race/ethnicity, highest level of education completed, employment status, and insurance type. Clinic participants are asked if they experience problems with having a conversation, reading, writing/typing, remembering things, paying attention, making decisions/solving problems, and the importance of addressing these areas in clinic.

Results: Of the 63 participants, 49% had an acquired brain injury (ABI) and 56% had an SCI. Individuals served in our clinic have a mean age of 38 years old, are primarily male (68%), are Black or African American (75%), and were unemployed at the time of admission (98%). Fifty-seven individuals (ABI = 29, SCI = 30, dual ABI and SCI = 2) responded to questions about difficulties in communication and cognition at clinic intake of which 40 of those individuals identified one or more challenges in these areas. Writing/typing was the most prevalent communication complaint, whereas remembering was the most frequently reported cognitive challenge. One participant completed these questions at clinic discharge, demonstrating improvement in communication and cognition.

Conclusions: The Georgia RSVP Clinic provides opportunity to understand uninsured adults who experience a brain injury or SCI. Clinic data provide insight on important patient experiences related to problems with communication and cognition. The clinic offers a unique opportunity to observe the "invisible" population of individuals who experience brain injury and SCI who do not have access to resources in Georgia.