Session Title: Research Spotlight: Pediatric Rehabilitation
Session Time: None. Available on demand.
Disclosures: Hetal Patel, MD: No financial relationships or conflicts of interest
Objective: To investigate and characterize factors related to admission to pediatric or adult IRFs among adolescents and compare the rehabilitation outcomes at these two facility types.
Design: Single center retrospective cohort studySetting : An urban Level 1 trauma center who received rehabilitation medicine consultations between 2017 and 2019.Participants : All patients between the ages of 15 and 18 (n=96) who received a rehabilitation medicine consultation between 2017 and 2019 were identified from the consult tracking database.
Interventions: No interventions were evaluated in this study.
Main Outcome Measures: Overall rehabilitation length of stay and Functional Independence Measure changes.
Results: The most common injury types were traumatic brain injury (TBI=49%) and spinal cord injury (SCI=21%). Overall, 45.8% of patients were discharged to IRF after acute hospitalization. Adolescent patients were more likely to undergo rehabilitation at an adult facility versus a pediatric facility if they were Black compared to white (relative risk, RR=2.5; 95% confidence interval, CI=1.12-5.56), had experienced violence as the etiology of injury (RR=2.0, CI=1.10-3.77), had Medicaid compared to private insurance (RR=2.15, CI= 1.01-4.59), or had SCI compared to TBI as a primary diagnosis (RR=2.43, CI=1.08-5.44). Admission to pediatric IRF was associated with longer length of stay than admission to adult IRF when adjusted for diagnosis (30.86±21.82 vs. 24.33±18.17 days; p=0.046), but Functional Independence Measures did not differ.Conclusions: There were significant differences in patient populations admitted to adult versus pediatric IRFs. In this hospital system, adolescents experiencing systemic disadvantages were more likely to discharge to an adult IRF compared to a pediatric IRF from a combined adult and pediatric Level 1 trauma center. Identification of these disparities will help to address inequity in adolescent rehabilitation at this facility and may motivate additional multi-center investigations.
Level of Evidence: Level III
To cite this abstract in AMA style:Patel H, Barnett HM, Bunnell AE, Fuentes M. Disparities in Admission to Pediatric and Adult Inpatient Rehabilitation Facilities Among Adolescents [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/disparities-in-admission-to-pediatric-and-adult-inpatient-rehabilitation-facilities-among-adolescents/. Accessed December 3, 2023.
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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/disparities-in-admission-to-pediatric-and-adult-inpatient-rehabilitation-facilities-among-adolescents/