Access to inpatient rehabilitation after violence-related traumatic brain injury.
OBJECTIVE
To examine injury characteristics, demographics, and discharge disposition after traumatic brain injury of violent or nonviolent cause.


METHODS
Cohort study.


METHODS
Level I trauma center.


METHODS
Patients (N=1807) admitted with a Head Abbreviated Injury Score (AIS) of 2 or more over a 2-year period.


METHODS
Not applicable.


METHODS
Injury cause was classified as violent or nonviolent. Discharge disposition was classified as home, inpatient rehabilitation, skilled nursing facility (SNF), and other.


RESULTS
The violence group was more likely to be male, to include individuals from diverse racial groups, to have an alcohol level above the legal limit, to have a more severe Head AIS, and to have Medicaid funding and equal access to inpatient rehabilitation compared with the nonviolence group. The violence group, though, was more likely to be discharged to home than to inpatient rehabilitation and more likely to be discharged to inpatient rehabilitation than to an SNF. The nonviolence group had a longer acute care length of stay and a higher rate of injuries to other body systems.


CONCLUSIONS
People with violence-related injuries often present unique rehabilitation challenges. After accounting for injury severity and demographics, there was no evidence of bias against the violently injured in gaining access to inpatient rehabilitation services.
Esselman
Peter C
PC
Department of Rehabilitation Medicine, University of Washington, Seattle, USA. esselman@u.washington.edu
Dikmen
Sureyya S
SS
Bell
Kathleen
K
Temkin
Nancy R
NR
D015998:Abbreviated Injury Scale; D000328:Adult; D017677:Age Distribution; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D000704:Analysis of Variance; D001930:Brain Injuries / Q000209:etiology / Q000534:rehabilitation; D015984:Causality; D015331:Cohort Studies; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006302:Health Services Research; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data*; D044469:Racial Groups / Q000706:statistics & numerical data; D012042:Registries; D017678:Sex Distribution; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014754:Violence / Q000706:statistics & numerical data*; D014861:Washington / Q000453:epidemiology