100 Post-Acute Care Setting is Associated with Employment After Severe Burn Injury

Abstract

Despite the growing use of post-acute care in the United States, few studies have examined differences in long-term outcomes by specific post-acute care setting. Adult burn survivors represent a population that exhibit impaired long-term outcomes and often require post-acute care. Currently, limited data exist regarding which care setting provides the most benefit to this population. The purpose of this study is to examine differences in long-term employment outcomes of adult burn survivors by post-acute care setting. Data was obtained from the Burn Model System National Database between 1994 and 2016. Adult burn survivors who were alive at discharge and required post-acute care following acute care discharge were included. The population was divided into two groups - those who received post-acute care at an inpatient rehabilitation facility (IRF Group) and those who received post-acute care at a skilled nursing facility, long-term care hospital, or other extended care facility (Other Rehab Group). Employment status was assessed at 12 months post injury. Propensity score matching (controlling for 16 demographic and clinical variables) and logistic regression were used to determine the impact of post-acute care setting on employment status. This study included a total of 695 burn survivors (447 in the IRF Group; 248 in the Other Rehab Group). Individuals in the IRF Group had larger burns and were more likely to have an inhalation injury and to have undergone an amputation. Additional demographic and clinical characteristics can be found in Table 1. Logistic regression analysis using propensity score matching found the IRF Group had over 9 times increased odds of being employed at 12 months post-injury compared to the Other Rehab Group (p=0.046). Inpatient rehabilitation facilities provided a long-term benefit for burn survivors in terms of regaining employment when compared to other acute care settings such as skilled nursing facilities, long-term care hospitals, and other extended care facilities. 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 inpatient rehabilitation facilities in this population. Demographic and clinical characteristics of the study population Demographic and clinical characteristics of the study population