Abstract
Objective
To examine differences in long-term employment outcomes in the postacute care setting.
Design
Retrospective review of the prospectively collected Burn Model System National Database.
Setting and Participants
A total of 695 adult survivors of burn injury enrolled between May 1994 and June 2016
who required postacute care at a Burn Model System center following acute care discharge
were included. Participants were divided into 2 groups based on acute care discharge
disposition. Those who received postacute 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 postinjury. Propensity score matching and logistic
regression were utilized to determine the effect of postacute 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 postinjury, the IRF group had over
9 times increased odds of being employed compared to the Other Rehab group, using
propensity score matching (P=.046).
Conclusions
While admitting patients with more severe injuries, IRFs provided a long-term benefit
for survivors of burn injury in terms of regaining employment. Given the current lack
of evidence-based guidelines on postacute care decisions, the results of this study
shed light on the potential benefits of the intensive services provided at IRFs in
this population.
Keywords
List of abbreviations:
BMS (Burn Model System), IRF (inpatient rehabilitation facility), LTCH (long-term care hospital), MCS (Mental Component Summary), PAC (postacute care), PCS (Physical Component Summary), SNF (skilled nursing facility), TBSA (total body surface area)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 03, 2019
Footnotes
Supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (grant no. 90DP0035 and 90DPBU0001).
The contents of this manuscript do not necessarily represent the policy of the National Institute on Disability, Independent Living, and Rehabilitation; the Administration for Community Living; or the Department of Health and Human Services.
Disclosures: none.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
