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.

中文翻译：

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住院时间可缓和小儿脑损伤中付款人来源与功能结局之间的关系。

目的

检查种族/民族，康复住院时间（LOS）和付款人来源对获得性脑损伤（ABI）患儿住院康复后功能状态的影响程度。

设计

儿科康复医院的回顾性队列研究包括485名ABI患者。

方法

儿童功能独立性测验（WeeFIM）分数转换为年龄校正的发育功能商数（DFQ），以检查种族/民族，LOS和付款人来源（公共保险还是私人）对功能结局的影响，同时控制年份。入院，入院DFQ，康复时间，年龄和脑损伤的病因。

结果

有公共保险的儿童和有较长LOS的儿童的出院DFQ得分往往较低。没有种族/民族的主要影响，但发现付款人来源×LOS有显着的交互作用（p <.001）。相互作用的进一步细分显示，主要是当LOS超过28天时，具有公共保险的儿童的DFQ分数较低（p = .001）。

结论

既有公共保险又有LOS超过4周的ABI儿童往往在住院康复后的功能结局较差。由于所有孩子都在同一设施接受服务，因此付款人来源可能充当其他社会人口统计学因素的替代者。