Article

OBJECTIVE: To examine variations in processes of pediatric inpatient
rehabilitation care related to family-centered care, management of
neurobehavioral and psychosocial needs, and community reintegration after
traumatic brain injury. SETTING: Nine acute rehabilitation facilities from
geographically diverse areas of the United States. PARTICIPANTS: A total of 174
children with traumatic brain injury. DESIGN: Retrospective chart review. MAIN
MEASURES: Adherence to care indicators (the number of times recommended care was
delivered or attempted divided by the number of times care was indicated).
RESULTS: Across facilities, adherence rates (adjusted for difficulty of delivery)
ranged from 33.6% to 73.1% (95% confidence interval, 13.4-53.9, 58.7-87.4) for
family-centered processes, 21.3% to 82.5% (95% confidence interval, 6.6-36.1,
67.6-97.4) for neurobehavioral and psychosocial processes, and 22.7% to 80.3%
(95% confidence interval, 5.3-40.1, 68.1-92.5) for community integration
processes. Within facilities, standard deviations for adherence rates were large
(24.3-34.9, family-centered domain; 22.6-34.2, neurobehavioral and psychosocial
domain; and 21.6-40.5, community reintegration domain). CONCLUSION: The current
state of acute rehabilitation care for children with traumatic brain injury is
variable across different quality-of-care indicators addressing neurobehavioral
and psychosocial needs and facilitating community reintegration of the patient
and the family. Individual rehabilitation facilities demonstrate inconsistent
adherence to different indicators and inconsistent performance across different
care domains.

Langue : ANGLAIS