Background: Little is known about short-term rehabilitative needs after trauma, information essential for policy, resource allocation, planning, and personnel training associated with trauma rehabilitation. This study examined the status of a high-risk group of trauma patients - motor vehicle crash survivors with head injuries - as they were discharged to home. Methods: A retrospective case series was conducted using the 1997 trauma registry to identify eligible adults. Data on demographics, finances, injury severity, complexity of hospital care, functional and medical status and post-discharge follow-up were abstracted from medical records and hospital databases. Results: Thirty-four cases were reviewed. Data will be presented. At discharge, rehabilitative needs associated with musculoskeletal injury, brain injury, skin integrity and pain management were identified with 55% of patients having needs in two or more domains. Fifty-four percent were referred to home health care. Only 62% of patients returned for follow-up within this institution. The pattern of clinics attended was different from the pattern of clinic referrals at discharge. Within 6 weeks of discharge, 24% of patients were seen in the Emergency Department and 6% had trauma-related readmissions. Conclusions: This study documents the multidimensional needs of this group of trauma survivors at discharge to home. Mobility skills were formally assessed more often than either self-care skills or cognition possibly resulting in an underestimate of the amount of disability experienced by this group. There was a gap in continuity of care from hospital to the outpatient setting. Models for continuity-focused trauma care are ripe for description, implementation and evaluation.
Learning Objectives: 1. Identify broader needs of multiply injured head injured trauma survivors 2. Describe domains of medical and rehabilitative need at discharge from acute trauma care 3. Recognize gap in continuity of care between hospital and home and potential consequences of gap
Keywords: Outcomes Research, Disability
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.