Factors Predicting Rehabilitative Service Provision in Adults with Traumatic Brain Injury.
Approximately 300,000 people sustain a traumatic brain injury (TBI) each year; however, a limited number receive formal speech-language, occupational, and physical therapy rehabilitation. Consequently, a large number of individuals may not meet their maximum potential outcomes following TBI. Little is known about the factors that may affect access to rehabilitation, the amount of rehabilitation provided in varying settings, or participation patterns in rehabilitation programs. This project addressed three research goals: defining the relationship between a number of independent variables following TBI and patient access to rehabilitative services, the relationship between the independent variables and the amount of TBI rehabilitative service provided, and the relationship between independent variables and discharge disposition following inpatient care for TBI. The medical records of 712 adults incurring TBI as a result of motor vehicle accidents were examined. Logistic regression, odds ratio, t-tests, analysis of variance, analysis of covariance, and multinomial regression were used to evaluate the relationship between the independent and dependent variables in the study. Results indicate that admission to the intensive care unit (ICU), diagnosis of orthopedic impairment, and discharge disposition were significant predictors of physical, occupational, and speech therapy service provision following TBI. Gender and primary insurance provider were significant predictors of speech therapy, but not physical or occupational therapies. Admission to the ICU was a significant predictor of the amount of occupational and speech therapy provided following TBI. Age, admission to the ICU, length of stay, and primary insurance provider were significant predictors of discharge disposition following initial hospitalization.