Inpatient length of stay moderates the relationship between payer source and functional outcomes in pediatric brain injury. (23rd August 2020)

• Record Type: Journal Article
• Authors: Juliano, Anthony C.; Lequerica, Anthony H.; Marino, Cherylynn; Marchetta, Claire; DeLuca, John
• Is Part Of: Brain injury. Volume 34:Number 10(2020)
• Page Start: 1395
• Page End: 1400
• Publication Date: 2020-08-23
• Subjects: Pediatric -- functional status -- insurance -- demographics; Brain damage -- Periodicals; Brain -- Wounds and injuries -- Periodicals; Brain Injuries -- Periodicals; 617.481
• DOI: 10.1080/02699052.2020.1802666
• Languages: English
• ISSNs: 0269-9052

Abstract

ABSTRACT: Objective: To examine the extent to which race/ethnicity, length of rehabilitation hospital stay (LOS), and payer source contribute to functional status following inpatient rehabilitation in children with acquired brain injury (ABI). Design: Retrospective cohort study from a pediatric rehabilitation hospital including 485 individuals with ABI. Methods: Functional Independence Measure for Children (WeeFIM) scores were transformed into age-corrected Developmental Functional Quotients (DFQ) to examine the effects of race/ethnicity, LOS, and payer source (public insurance vs. private) on functional outcomes while controlling for year of admission, admission DFQ, time to rehabilitation, age, and brain injury aetiology. Results: Discharge DFQ scores tended to be lower for children with public insurance as well as those with longer LOS. There was no main effect of race/ethnicity, but a significant interaction effect for payer source×LOS ( p < .001) was found. Further breakdown of the interaction showed lower discharge DFQ scores for children with public insurance primarily when LOS exceeded 28 days ( p = .001). Conclusion: Children with ABI who have both public insurance and LOS beyond 4 weeks tend to have poorer functional outcomes after inpatient rehabilitation. Because all children were receiving services at the same facility, payer source may be functioning as a proxy for other sociodemographic factors.