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Journal Article

Citation

Espinoza LF, Simko LC, Goldstein R, McMullen KA, Slocum C, Silver JK, Herndon DN, Suman OE, Meyer WJ, Gibran NS, Kowalske K, Zafonte R, Ryan CM, Schneider JC. Arch. Phys. Med. Rehabil. 2019; ePub(ePub): ePub.

Affiliation

Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA. Electronic address: jcschneider@partners.org.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.apmr.2019.06.007

PMID

31278926

Abstract

OBJECTIVE: To examine differences in long-term employment outcomes of adult burn survivors by post-acute care setting.

DESIGN: Retrospective review of the prospectively collected Burn Model System National Database. SETTING: and Participants: A total of 695 adult burn survivors enrolled between May 1994 and June 2016 who required post-acute care at a Burn Model System center following acute care discharge were included. Participants were divided into two groups based on acute care discharge disposition. Those who received post-acute care at an inpatient rehabilitation facility (IRF) following acute care were included in the IRF group (N=447), and those who were treated at a skilled nursing facility, long-term care hospital, or other extended care facility following acute care were included in the Other Rehab Group (N=248). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Employment status at 12 months post injury. Propensity score matching and logistic regression were utilized to determine the impact of post-acute care setting on employment status.

RESULTS: Individuals in the IRF Group had larger burns and were more likely to have an inhalation injury and to undergo amputation. At 12 months post-injury, the IRF Group had over 9 times increased odds of being employed compared to the Other Rehab Group, using propensity score matching (p=0.046).

CONCLUSIONS AND IMPLICATIONS: While admitting patients with more severe injuries, IRFs provided a long-term benefit for burn survivors in terms of regaining employment. Given the current lack of evidence-based guidelines on post-acute care decisions, the results of this study shed light on the potential benefits of the intensive services provided at IRFs in this population.

Copyright © 2019. Published by Elsevier Inc.


Language: en

Keywords

burn injury; employment; inpatient rehabilitation facility; post-acute care; skilled nursing facility

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