Are Social Determinants of Health Associated With Onset of Rehabilitation Services in Patients Hospitalized for Traumatic Brain Injury?
J Head Trauma Rehabil
; 38(2): 156-164, 2023.
Article
en En
| MEDLINE
| ID: mdl-36730956
ABSTRACT
OBJECTIVE:
To examine the impact of community-level social determinants of health (SDoH) on the onset of occupational therapy (OT) and physical therapy (PT) services among individuals hospitalized for traumatic brain injury (TBI).SETTING:
14 acute care hospitals in the state of Colorado.PARTICIPANTS:
We studied 5825 adults with TBI.DESIGN:
In a secondary analysis of de-identified electronic health record data, we performed multivariable logistic and linear regressions to calculate odds ratios (ORs) and 95% CIs for the likelihood of receiving services and duration to initiation of services among those who received them. MAINMEASURES:
Community-level SDoH, receipt of rehabilitation services, and onset of rehabilitation services.RESULTS:
Multivariable logistic and linear regressions revealed that those in top quartiles for community income were associated with duration to OT services, ranging from OR = 0.33 [05% CI, 0.07, 0.60] for quartile 2 to 0.76 [0.44, 1.08] for quartile 4 compared with those with the lowest quartile. Only the top quartile differed significantly for duration to PT services (0.63 [0.28, 0.98]). Relative to those with below the median community percentage of high school degree, those with above the median were associated with duration to PT services only (-0.32 [-0.60, -0.04]). Neither community percentage with bachelor's degree nor rural-urban designation was associated with duration to either therapy service.CONCLUSION:
Further research is needed to determine whether our SDoH variables were too diffuse to capture individual experiences and impacts on care or whether community-level education and income, and rurality, truly do not influence time to therapy for patients hospitalized with TBI. Other, individual-level variables, such as age, comorbidity burden, and TBI severity, demonstrated clear relationships with therapy onset. These findings may help therapists evaluate and standardize equitable access to timely rehabilitation services.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Terapia Ocupacional
/
Lesiones Traumáticas del Encéfalo
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Límite:
Adult
/
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Head Trauma Rehabil
Asunto de la revista:
REABILITACAO
/
TRAUMATOLOGIA
Año:
2023
Tipo del documento:
Article