Determining differences in post discharge outcomes among catastrophically and noncatastrophically sponsored outpatients with spinal cord injury.
This study tested differences in functional independence status, level of psychologic distress and extent of handicap experienced after discharge from inpatient rehabilitation among a group of 125 outpatients with spinal cord injury (SCI) sponsored by one of three types of rehabilitation insurance payors: catastrophic (Michigan Automobile No-Fault and Workers' Disability Compensation), Medicaid and third-party privates. Outcome measures included the functional independence measure, the brief symptom inventory and the Craig handicap assessment reporting technique. Insurance data was obtained via medical chart reviews and interviews that were conducted either face-to-face or by telephone, using the benefits coverage inventory. No differences in terms of post discharge functional independence across subjects sponsored by the three payors was found when controlling for neurologic status. However, SCI subjects sponsored by different payors reported receiving different amounts of benefits. Subjects also differed on the extent of psychologic distress experienced after discharge and the extent of their handicaps. SCI subjects sponsored by Medicaid reported receiving fewer benefits, being more distressed and experiencing greater handicap in comparison to others. Third-party privately sponsored subjects, conversely, experienced less handicap and distress than did the study's other subjects.
Tate
D G
DG
Department of Physical Medicine and Rehabilitation, University of Michigan Medical Center, Ann Arbor.
Forchheimer
M
M
Daugherty
J
J
Maynard
F
F
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D003863:Depression / Q000175:diagnosis; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D007342:Insurance Benefits; D007349:Insurance, Health, Reimbursement; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010045:Outpatients; D013119:Spinal Cord Injuries / Q000191:economics* / Q000534:rehabilitation*; D013315:Stress, Psychological / Q000523:psychology; D014481:United States; D014942:Workers' Compensation