title: Regional differences in rehabilitation needs, rehabilitation access, and physical outcomes among multiple trauma survivors.
abstract: OBJECTIVE
  The aims of this study were to compare regional differences in perceived needs for postacute rehabilitation services, perceived barriers to postacute rehabilitation services, and long-term functional and physical health outcomes among multiple trauma survivors.
  
  
  METHODS
  A population-based cohort study with retrospective measures of exposure and cross-sectional health outcomes measures was conducted in regions with different levels of rehabilitation services availability in the province of Quebec, Canada. The study included 435 participants, aged 18-65 yrs, admitted to level I or level II trauma centers in 2000-2001, who required rehabilitation services. The participants were interviewed by telephone 2-4 yrs postinjury. Needs for (yes/no) and perceived barriers (yes/no) to obtain 18 posttraumatic rehabilitation services were assessed. Physical health was measured with the medical outcome study SF-12 and functional status with the functional independence measure.
  
  
  RESULTS
  There were no significant regional differences in the proportions of perceived barriers to functional rehabilitation (39.4%), to social/vocational rehabilitation (52.2%), and to community integration services (46.5%). Adjusted-SF-12 and functional independence measure scores were similar across regions.
  
  
  CONCLUSIONS
  Contrary to expectations, there were no regional differences in perceived barriers to rehabilitation services for multiple trauma survivors. Rather, surprisingly high proportions of barriers were reported across the province.
authors.affiliation: Research Center of the Centre hospitalier affilié universitaire de Québec, Laval University, Quebec City, Canada.
authors.forename: Marie-Josée
authors.initials: MJ
authors.lastname: Sirois
authors.forename: Clermont E
authors.initials: CE
authors.lastname: Dionne
authors.forename: André
authors.initials: A
authors.lastname: Lavoie
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000534:rehabilitation*; D011792:Quebec; D012047:Rehabilitation Centers; D055815:Young Adult