title: Inpatient and postdischarge rehabilitation services provided in the first year after spinal cord injury: findings from the SCIRehab Study.
abstract: OBJECTIVE
  To examine the amount and type of therapy services received in inpatient and postdischarge settings during the first year after spinal cord injury (SCI).
  
  
  METHODS
  Prospective observational longitudinal cohort design. Data were obtained from systematic recording of interventions by clinicians and from patient interview.
  
  
  METHODS
  Inpatient and postdischarge rehabilitation programs.
  
  
  METHODS
  Patients (N=493) with traumatic SCI admitted to 6 rehabilitation centers participating in the SCIRehab study.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Hours of therapy by physical therapy (PT), occupational therapy (OT), speech therapy, recreation therapy, psychology, social work/case management, and nursing education during initial inpatient rehabilitation and postdischarge up to the first anniversary of injury. Inpatient data were collected prospectively by the treating clinicians; postdischarge service data were collected by patient self-report during follow-up interviews.
  
  
  RESULTS
  Of the total hours spent on these rehabilitation interventions during the first year after injury, 44% occurred after discharge from inpatient rehabilitation. Participants received 56% of their PT hours after discharge and 52% of their OT hours, but only a minority received any postdischarge services from other rehabilitation disciplines. While wide variation was found in the total hours of inpatient treatment across all disciplines, the variation in the total hours of postdischarge services was greater, with the interquartile range of postdischarge services being twice that of the inpatient services.
  
  
  CONCLUSIONS
  SCI rehabilitation is often given in a care continuum, with inpatient rehabilitation being only the beginning. Reductions in inpatient SCI rehabilitation length of stay are well documented, but the postdischarge services that may replace some inpatient treatment appear to be greater than previously reported. The availability and impact of postdischarge care should be studied in greater detail to capture the wide array of postdischarge services and outcomes.
authors.affiliation: Craig Hospital, Englewood, CO, USA. gale@craig-hospital.org.
authors.forename: Gale G
authors.initials: GG
authors.lastname: Whiteneck
authors.forename: Julie
authors.initials: J
authors.lastname: Gassaway
authors.forename: Marcel P
authors.initials: MP
authors.lastname: Dijkers
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Lammertse
authors.forename: Flora
authors.initials: F
authors.lastname: Hammond
authors.forename: Allen W
authors.initials: AW
authors.lastname: Heinemann
authors.forename: Deborah
authors.initials: D
authors.lastname: Backus
authors.forename: Susan
authors.initials: S
authors.lastname: Charlifue
authors.forename: Pamela H
authors.initials: PH
authors.lastname: Ballard
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Zanca
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data*; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D013997:Time Factors; D015599:Trauma Severity Indices