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Postacute Care Setting Is Associated With Employment After Burn Injury

      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)
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