Utilization of inpatient rehabilitation services among traumatically injured children discharged from pediatric trauma centers.

This paper investigates factors that predict whether or not children treated at pediatric trauma centers are discharged to inpatient rehabilitation. Variables pertaining to functional impairments, injury severity and institutional factors explained over 45% of the variance in discharge disposition. It appears that a good deal of rationality pervades the decision as to whether patients are discharged to home or to rehabilitation. The extent of functional impairments and the severity of injury are closely related to these discharge decisions, as one would expect in a well-functioning discharge planning system. However, there are indications that discharge decisions are also affected by factors that ideally should be external to the decision process. Chief among these is whether or not the trauma center has an onsite rehabilitation unit. Patients treated at trauma centers that have onsite rehabilitation units are significantly more likely to be discharged to rehabilitation than patients treated at trauma centers without onsite rehabilitation.