Trauma-rehabilitation connections: Discharge and admission decisions for children

• Published in: Pediatric rehabilitation Vol. 1; no. 3; pp. 131 - 146
• Main Authors: Osberg, J. Scott, Unsworth, Carolyn A.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 1997
• Subjects: Ambulatory Care; Child; clinical decision-making; Decision Making; Family; Guidelines as Topic; Health Services Accessibility; Home Care Services; Hospitalization; Humans; injury; Insurance Coverage; Insurance, Health; Patient Admission; Patient Discharge; Patient Participation; Patient Selection; Personal Satisfaction; protocols; referral; Referral and Consultation; Rehabilitation Centers - organization & administration; transfers; Trauma Centers - organization & administration; Wounds and Injuries - rehabilitation
• ISSN: 1363-8491; 1464-5270
• DOI: 10.3109/17518429709167352

Paediatric discharge coordinators and rehabilitation admission coordinators were surveyed about how children are selected for rehabilitation. The following areas are covered: (1) the decision process, and how children are selected for rehabilitation; (2) who is involved in making acute-care discharge and rehabilitation admission decisions; (3) factors that guide selection of children for rehabilitation; and (4) satisfaction with referral practices. Surveys were completed by 30 trauma discharge and rehabilitation admission coordinators, recruited from paediatric trauma units and paediatric/general rehabilitation units nationwide. Most respondents were satisfied with transfers, although some voiced concerns about constraints placed on referrals by insurance. Even when inpatient rehabilitation was clearly needed, 40% said insurance status still affected whether children were admitted. There was little evidence that any uniform criteria are used to make decisions. Half had no training in discharge/admission planning and half did not base decisions on functional assessments. Although guidelines are increasingly used in clinical decision-making, few are available concerning critical decisions about which children receive inpatient rehabilitation following trauma.