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Affiliation
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Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA; Department of Pediatrics at the University of Washington; Department of Epidemiology at the University of Washington. |
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Abstract
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OBJECTIVE: To compare motor and cognitive functional independence scores between Hispanic, non-Hispanic Black (NHB) and non-Hispanic White (NHW) children with traumatic brain injury (TBI) after discharge from inpatient rehabilitation.
DESIGN: Retrospective cohort study using the Uniform Data System for Medical Rehabilitation national dataset from years 2002-2012. SETTING: Inpatient rehabilitation units. PARTICIPANTS: 10,141 children 6 months to 18 years of age who received inpatient rehabilitation for TBI. INTERVENTIONS: not applicable. MAIN OUTCOME MEASURES: Motor and cognitive functional independence after discharge from inpatient rehabilitation; adjusting for age, gender, admission function, length of stay, insurance and region.
RESULTS: Inpatient rehabilitation therapy improved functional independence for all children. Younger age, lower admission functional independence scores and Medicaid insurance were associated with lower functional independence at discharge. Hispanic and NHB children had lower discharge cognitive scores compared to NHW children; however differences were small and were partially explained by insurance status and region. Children who received rehabilitation therapy at pediatric facilities had greater cognitive improvement.
CONCLUSION: While racial/ethnic disparities are small, minority children are more likely to be younger, to have Medicaid and to be cared for at non-pediatric facilities, factors that increase their risk for lower functional outcomes.
Language: en |