Abstract
Objective
To compare motor and cognitive functional independence scores between Hispanic, non-Hispanic
black (NHB), and non-Hispanic white (NHW) children with traumatic brain injury (TBI)
after discharge from inpatient rehabilitation.
Design
Retrospective cohort study using the Uniform Data System for Medical Rehabilitation
national dataset from the years 2002 to 2012.
Setting
Inpatient rehabilitation units.
Participants
Children (N=10,141) aged 6 months to 18 years who received inpatient rehabilitation
for TBI.
Interventions
Not applicable.
Main Outcome Measures
Motor and cognitive functional independence after discharge from inpatient rehabilitation,
adjusting for age, sex, admission function, length of stay, insurance, and region.
Results
Inpatient rehabilitation therapy improved functional independence for all children.
Younger age, lower admission functional independence scores, and Medicaid insurance
were associated with lower functional independence at discharge. Hispanic and NHB
children had lower discharge cognitive scores compared with NHW children; however,
differences were small and were partially explained by insurance status and region.
Children who received rehabilitation therapy at pediatric facilities had greater cognitive
improvement.
Conclusions
While racial/ethnic disparities are small, minority children are more likely to be
younger, to have Medicaid, and to be cared for at nonpediatric facilities, factors
that increase their risk for lower functional outcomes.
Keywords
List of abbreviations:
CI (confidence interval), DFQ (developmental functional quotient), NHB (non-Hispanic black), NHW (non-Hispanic white), TBI (traumatic brain injury), UDSMR (Uniform Data System for Medical Rehabilitation)To read this article in full you will need to make a payment
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References
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Article info
Publication history
Published online: March 04, 2015
Footnotes
Supported by the National Institute of Child Health and Human Development (grant no. 1K23HDO7843-01), the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (grant no. R49 CE 001021), and Seattle Children's Hospital Center for Diversity and Health Equity.
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
