Admitting paediatric trauma patients to rehabilitation following acute care: Decision making practices in the USA and Australia

• Published in: Pediatric rehabilitation Vol. 1; no. 4; pp. 207 - 218
• Main Authors: Unsworth, Carolyn A., Osberg, J. Scott, Graham, Annette
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 1997
• Subjects: Analysis of Variance; Australia; Chi-Square Distribution; Child; children; clinical decision-making; Decision Making; Family; Guidelines as Topic; Health Knowledge, Attitudes, Practice; Health Services Accessibility; Health Services Needs and Demand; Health Services Research; Humans; Insurance Coverage; Patient Admission; Patient Discharge; Patient Selection; protocols; Referral and Consultation; Rehabilitation Centers - organization & administration; Social Environment; Trauma Centers - organization & administration; Trauma Severity Indices; United States; Wounds and Injuries - rehabilitation; Australia; United States
• ISSN: 1363-8491; 1464-5270
• DOI: 10.3109/17518429709167361

Paediatric patient access to rehabilitation services following trauma has significant long-term implications for clients, their families and the community. The aim of this research was to examine and compare the process by which patients are discharged from acute care and enter rehabilitation in the USA and Australia. The subjects were 31 American and 29 Australian discharge and rehabilitation admission coordinators. Subjects were surveyed about how they currently make trauma to rehabilitation referrals for children. Clinicians in both countries considered the severity of a child's injury and their social situation the most important factors when determining placement for a child. However, there were differences between Australian and US respondents in terms of how important they considered the factor 'medical coverage'. In addition, it was found that clinicians are not consistently using both standardized assessments and formal guidelines to assist them to determine which children should receive rehabilitation following acute care. Benefits of this research include a greater understanding of clinician discharge and admission decision making, and the equity of such decisions. However, further research is required on the influence of payment systems on access to paediatric rehabilitation.