Assessing Factors Influencing Discharge Disposition for Pediatric Patients with Inpatient Rehabilitation Requirements

Valentine U. Chukwuma, PhD (Vanderbilt University School of Medicine, Nashville, Tennessee); Valentine U. Chukwuma, PhD (Vanderbilt University School of Medicine, Nashville, Tennessee); Elizabeth Martin, MD, MPH, MHS; Sarah A. Welch, DO; Katherine Hedden, PT, DPT, PCS; Camille Heider, MOT, OTR/L; Philip J. Davis; Sterling Haring, DO, MPH; Elizabeth Martin, MD, MPH, MHS; Sarah A. Welch, DO

Meeting: AAPM&R Annual Assembly 2020

Categories: Pediatrics (2020)

Session Information

Session Title: Virtual Poster Hall

Session Time: None. Available on demand.

Disclosures: Valentine U. Chukwuma, PhD: No financial relationships or conflicts of interest
Valentine U. Chukwuma, PhD: No financial relationships or conflicts of interest

Objective: Identifying the factors influencing the discharge disposition of pediatric patients with inpatient rehabilitation needs.

Design: Retrospective Cohort Study Setting : Children’s hospital of a large academic medical center. Participants : 202 pediatric patients discharged during January 2017 – October 2019 with a recommendation for inpatient rehabilitation.

Interventions: not applicable.

Main Outcome Measures: Discharge to home or inpatient rehabilitation facility (IRF).

Results: Despite all included children having inpatient rehabilitation recommendations, only 101 (50.0%) were discharged to an IRF, with no correlation to sex (p=0.884) or age (p=0.485). While privately insured children appeared to have higher rates of discharge to an IRF than government-insured children, this was not statistically significant (p=0.103). There were no statistically significant differences between discharge to an IRF or home based on age. Children with government insurance in a state with a pediatric IRF (KY) were more likely to be discharged to an IRF than children with government insurance in a state without a pediatric IRF (TN). Children with a primary diagnosis of polytrauma (OR=30.6, p=0.003), spinal cord injury (OR=19.4, p < 0.001), stroke (OR=16.0, p=0.002), or brain injury (OR=12.4, p < 0.001) were more likely to be discharged to an IRF. Conclusions: About half of the children recommended for inpatient rehabilitation were discharged to IRF with the other half being discharged to home. While no statistically significant correlation was seen between discharge disposition and insurance type, age, or sex, children with severe primary diagnoses were more likely to be successfully discharged to an IRF. Children with government insurance in a state with a pediatric IRF were more likely to be discharged to an IRF than children with government insurance in a state without a pediatric IRF. Future studies involving multiple centers can provide additional data on the factors influencing discharge disposition, and insights on ways of improving rates of inpatient rehabilitation among this vulnerable population.

Level of Evidence: Level III

To cite this abstract in AMA style:

Chukwuma VU, Martin E, Welch SA, Hedden K, Heider C, Davis PJ, Haring S, Martin E, Welch SA. Assessing Factors Influencing Discharge Disposition for Pediatric Patients with Inpatient Rehabilitation Requirements [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/assessing-factors-influencing-discharge-disposition-for-pediatric-patients-with-inpatient-rehabilitation-requirements/. Accessed November 23, 2024.

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