Article

OBJECTIVE: To determine variations in care provided by 9 inpatient rehabilitation
units for children with traumatic brain injury (TBI) using newly developed
quality indicators. DESIGN: Retrospective cohort study. SETTING: Nine inpatient
rehabilitation units. PARTICIPANTS: Children (N=174; age range, 0-17y) admitted
for the inpatient rehabilitation of moderate to severe TBI. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: Adherence to 119 newly developed
quality-of-care indicators in 7 different domains: general care, family-centered
care, cognitive-communication, motor, neuropsychological, school, and community
integration. RESULTS: There was substantial variation both within and between
institutions in the percentage of patients receiving recommended care in the 7
domains. The lowest scores were found for the school domain. Only 5 institutions
scored above 50% for all quality indicators, and only 1 institution scored above
70% overall. Greater adherence to quality indicators was found for facilities
with a higher proportion of therapists with pediatric training and for facilities
that only admitted children. Patient volume was not associated with adherence to
quality indicators. CONCLUSIONS: The results indicate a tremendous variability
and opportunity for improvement in the care of children with TBI.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS