title: Relation between inpatient and postdischarge services and outcomes 1 year postinjury in people with traumatic spinal cord injury.
abstract: OBJECTIVE
  To examine the association between inpatient and postdischarge rehabilitation services and function, life satisfaction, and community participation 1 year after spinal cord injury (SCI).
  
  
  METHODS
  Prospective, observational.
  
  
  METHODS
  Six rehabilitation facilities.
  
  
  METHODS
  Patients with SCI (N=1376).
  
  
  METHODS
  None.
  
  
  METHODS
  Satisfaction with Life Scale (SWLS), Craig Handicap Assessment and Reporting Technique (CHART), motor FIM (mFIM), and return to work/school at 1 year post-SCI.
  
  
  RESULTS
  Demographic and injury characteristics explained 49% of the variance in mFIM and 9% to 25% of the variance in SWLS and CHART social integration, mobility, and occupation scores. Inpatient rehabilitation services explained an additional 2% of the variance for mFIM and 1% to 3% of the variance for SWLS and CHART scores. More time in inpatient physical therapy (PT) was associated with higher mFIM scores; more time in inpatient therapeutic recreation (TR) and social work and more postdischarge nursing (NSG) were associated with lower mFIM scores. More inpatient PT and TR and more postdischarge PT were associated with higher mobility scores; more inpatient psychology (PSY) was associated with lower mobility scores. More postdischarge TR was associated with higher SWLS; more postdischarge PSY services was associated with lower SWLS. Inpatient TR was positively associated with social integration scores; postdischarge PSY was negatively associated with social integration scores. More postdischarge vocational counseling was associated with higher occupation scores. Differences between centers did not explain additional variability in the outcomes studied.
  
  
  CONCLUSIONS
  Inpatient and postdischarge rehabilitation services are weakly associated with life satisfaction and societal participation 1 year after SCI. Further study of the type and intensity of postdischarge services, and the association with outcomes, is needed to ascertain the most effective use of therapy services after SCI.
authors.affiliation: Crawford Research Institute, Shepherd Center, Atlanta, GA 30309, USA. Deborah_backus@shepherd.org
authors.forename: Deborah
authors.initials: D
authors.lastname: Backus
authors.forename: Julie
authors.initials: J
authors.lastname: Gassaway
authors.forename: Randall J
authors.initials: RJ
authors.lastname: Smout
authors.forename: Ching-Hui
authors.initials: CH
authors.lastname: Hsieh
authors.forename: Allen W
authors.initials: AW
authors.lastname: Heinemann
authors.forename: Gerben
authors.initials: G
authors.lastname: DeJong
authors.forename: Susan D
authors.initials: SD
authors.lastname: Horn
mesh_terms: D000328:Adult; D000367:Age Factors; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010045:Outpatients / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D012737:Sex Factors; D058992:Social Participation; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D014481:United States