OBJECTIVE: To examine differences in long-term employment outcomes of adult burn survivors by post-acute care setting.
DESIGN: Retrospective review of the prospectively collected Burn Model System National Database. SETTING: and Participants: A total of 695 adult burn survivors enrolled between May 1994 and June 2016 who required post-acute care at a Burn Model System center following acute care discharge were included. Participants were divided into two groups based on acute care discharge disposition. Those who received post-acute care at an inpatient rehabilitation facility (IRF) following acute care were included in the IRF group (N=447), and those who were treated at a skilled nursing facility, long-term care hospital, or other extended care facility following acute care were included in the Other Rehab Group (N=248). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Employment status at 12 months post injury. Propensity score matching and logistic regression were utilized to determine the impact of post-acute care setting on employment status.
RESULTS: Individuals in the IRF Group had larger burns and were more likely to have an inhalation injury and to undergo amputation. At 12 months post-injury, the IRF Group had over 9 times increased odds of being employed compared to the Other Rehab Group, using propensity score matching (p=0.046).
CONCLUSIONS AND IMPLICATIONS: While admitting patients with more severe injuries, IRFs provided a long-term benefit for burn survivors in terms of regaining employment. Given the current lack of evidence-based guidelines on post-acute care decisions, the results of this study shed light on the potential benefits of the intensive services provided at IRFs in this population.