New Study Shows Level of Rehab Care for Burn Survivors Significantly Impacts Employment Rate Post Injury
(Boston, MA) – A new study led by researchers from the Boston-Harvard Burn Injury Model System and members of the Harvard Medical School Department of Physical Medicine and Rehabilitation at Spaulding Rehabilitation Network looked at twenty years of burn survivor data and found a strong correlation between access to inpatient rehabilitation facility (IRF) level of care and better employment outcomes twelve months post injury. The report titled “Postacute Care Setting Is Associated with Employment After Burn Injury” was published in the November issue of the Archives of Physical Medicine and Rehabilitation. The study reports that burn survivors that received IRF care as opposed to other postacute care settings such as skilled nursing or long-term acute care were 9 times more likely to be employed 12 months post injury than those who did not receive the same level of care. To account for differences in the groups, the investigators used statistical methods to compare similar patients from each group.
“This study provides an opportunity to examine how care pathways impact outcomes. We found that burn survivors treated in a more intensive rehabilitative setting exhibited dramatically better employment outcomes. This helps us to better understand the differential value of various post-acute settings in this population. Additionally, this work sheds light on potential implications for other injury populations,” said Jeffrey Schneider, MD, Study Principal Investigator and Director of the Boston-Harvard Burn Injury Model System and Medical Director of the Burn and Trauma Rehabilitation Program at Spaulding.
A total of 695 adult survivors of burn injury enrolled between May 1994 and June 2016 who required postacute care following acute care discharge were included. Participants were divided into 2 groups based on acute care discharge disposition: those who received postacute care at an IRF and those who were treated at a skilled nursing facility, long-term care hospital, or other extended-care facility following acute care.
While admitting patients with more severe injuries, IRFs provided a long-term benefit for survivors of burn injury in terms of regaining employment. To be admitted into an IRF facility such as Spaulding Rehabilitation Hospital in Boston, patients must be able to actively participate and benefit from at least three hours of therapy a day. This generally is a mix of individual and group physical, occupational, and speech language therapies. Given the current lack of evidence-based guidelines on postacute care decisions for families and providers, the study team believes their results shed light on the potential benefits of the intensive services provided at IRFs in this population.
“My hope is insurers, providers and families can make care decisions with more evidence-based information on which level of care would be best not only for the immediate future but what will provide them the opportunity to achieve the highest outcomes possible a year or more post injury. There is more we can do for the burn survivor population and our team is excited by these results and believes further study is warranted,” said Schneider.
This study was published as part of the work by the Boston-Harvard Burn Injury Model System (BHBIMS), one of four Burn Model Systems funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) and dedicated to improving the lives of burn survivors. BHBIMS strives to provide the highest level of comprehensive burn care, beginning at the time of injury and extending through rehabilitation and eventual re-entry into community life. BHBIMS is also committed to conducting rigorous research, with a specific focus on the long-term functional and psychosocial outcomes of burn injury. The BHBIMS is a collaboration of Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Shriners Hospitals for Children – Boston, Brigham and Women’s Hospital, Harvard Medical School, and the Boston University School of Public Health.
About Spaulding Rehabilitation Network
A member of Partners HealthCare, the Spaulding Rehabilitation Network includes Spaulding Rehabilitation Hospital, with a main campus in Charlestown the 3rd ranked rehabilitation hospital in the country by U.S. News & World Report, along with Spaulding Rehabilitation Hospital Cape Cod, Spaulding Hospital Cambridge, Spaulding Nursing and Therapy Center Brighton, and 25 outpatient sites throughout Eastern Massachusetts. An acclaimed teaching hospital of Harvard Medical School and home to the Department of Physical Medicine and Rehabilitation, Spaulding is recognized as the top residency program in the U.S. in the 2019/2020 Doximity Residency Navigator. Spaulding also was recognized by the 2019 Disability Equality Index as a “Best Places to Work for Disability Inclusion.” For more information, please visit www.spauldingrehab.org.