Regional Variations in Rehabilitation Outcomes of Adult Patients With Traumatic Brain Injury: A Uniform Data System for Medical Rehabilitation Investigation.
Regional Variations in Rehabilitation Outcomes of Adult Patients With Traumatic Brain Injury: A Uniform Data System for Medical Rehabilitation Investigation.
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DOI：
10.1016/j.apmr.2020.07.011
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发表时间：
2021-01
影响因子：
4.3
通讯作者：
Wright, David W.
中科院分区：
文献类型：
--
作者：
Oyesanya, Tolu O.;Moran, Tim P.;Espinoza, Tamara R.;Wright, David W.
目的：研究在住院康复机构(IRF)接受护理的中重型颅脑损伤(TBI)成年患者康复效果的地区差异。我们对来自医疗康复统一数据系统的大型多中心数据集进行了二次分析。超过70%的美国IRF(美国)不适用。我们的样本包括175,358名成年脑外伤患者(年龄≥18岁)，他们在2004年至2014年期间从美国的国际救治框架入院和出院。合格的病因包括创伤性脑功能障碍组代码[02.21(创伤性、开放性损伤)和02.22(创伤性、闭合性损伤)]。出院功能状态(总体、认知和运动)、住院时间和出院回家。患者和临床特征因地理位置不同而显著不同，中位功能状态和住院时间以及出院患者的百分比也不同。此外，接受IRF治疗的地区、种族/民族、年龄、在IRF住院期间发生1次或1次以上跌倒、病例组合组和保险状况与出院功能状态、住院时间和出院回家相关。研究结果提供了接受IRF治疗的脑外伤患者预后的地理差异和潜在的护理差异的证据。需要更多的研究来确定有不良出院结果风险的脑外伤患者，以便为开发和测试干预措施提供信息，以减少这些患者的结果差异。
To examine regional differences in rehabilitation outcomes among adult patients with moderate-to-severe traumatic brain injury (TBI) who received care at an inpatient rehabilitation facility (IRF). We conducted a secondary analysis of a large, multi-center dataset from the Uniform Data System for Medical Rehabilitation. Over 70% of all IRFs in the United States (U.S.) Not applicable. Our sample consisted of 175,358 adult TBI patients (age ≥ 18), admitted and discharged from an IRF in the U.S. between 2004 and 2014. Qualifying etiology included traumatic brain dysfunction Impairment Group Codes [02.21 (traumatic, open injury) and 02.22 (traumatic, closed injury)]. Discharge functional status (total, cognitive, and motor), length of stay, and discharge to home. Patient and clinical characteristics varied significantly by geographic location, as did median functional status and length of stay, and percentage of patients discharged home. Also, the region where IRF care was received, race/ethnicity, age, occurrence of 1 or more falls during the IRF stay, case mix group, and insurance status were associated with discharge functional status, length of stay, and discharge to home. Findings provide evidence of geographic differences in outcomes and potential disparities in care of TBI patients who received IRF care. More research is needed to identify TBI patients at risk for poor discharge outcomes to inform development and testing of interventions to reduce disparities in outcomes for these patients.
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影响因子：
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作者：
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通讯作者：
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发表时间：
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影响因子：
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