Outcomes of social work and case management services during inpatient spinal cord injury rehabilitation: The SCIRehab project

The Journal of Spinal Cord Medicine, 2012 · DOI: 10.1179/2045772312Y.0000000064 · Published: January 1, 2012

Spinal Cord Injury Rehabilitation Social Support

Simple Explanation

This study investigates how social work and case management (SW/CM) services during inpatient rehabilitation after spinal cord injury (SCI) relate to patient outcomes. The researchers analyzed data from 1032 individuals with traumatic SCI who underwent inpatient rehabilitation at six different centers, examining the impact of various SW/CM interventions on their recovery and societal participation. The findings reveal that the intensity and type of SW/CM services significantly influence outcomes, such as discharge location and societal participation, emphasizing the importance of tailored support for individuals with SCI during rehabilitation.

Study Duration

2.5 years (enrollment period)

Participants

1032 individuals with traumatic SCI

Evidence Level

Prospective observational cohort

Key Findings

1
More SW/CM sessions dedicated to discharge planning for home and financial planning were associated with a higher likelihood of discharge to home.
2
Increased SW/CM sessions focused on discharge to non-home locations were linked to negative associations with societal participation outcomes.
3
Medicaid as a primary payer was associated with lower CHART Social Integration and Mobility scores, smaller likelihood of working or being in school and greater likelihood of rehospitalization after discharge.

Research Summary

This study examined the association between social work/case management (SW/CM) services during inpatient rehabilitation following spinal cord injury (SCI) and patient outcomes, using data from the SCIRehab project. The results indicated that the intensity and type of SW/CM services are associated with outcomes at rehabilitation discharge and 1-year post-injury. Specific SW/CM activities, such as discharge planning and financial planning, were linked to improved outcomes, while planning for non-home discharge showed negative associations with societal participation.

Practical Implications

Tailored Interventions

SW/CM services should be tailored to individual patient needs, focusing on discharge planning and financial support for those aiming for home discharge.

Resource Allocation

Rehabilitation centers should allocate resources to SW/CM services that support societal participation for patients being discharged to non-home settings.

Payer Considerations

Address the unique challenges faced by SCI patients with Medicaid or Medicare to improve their long-term outcomes.

Study Limitations

1
The SCIRehab sites are highly specialized centers for SCI rehabilitation, and thus, findings may not be generalizable to all rehabilitation facilities that provide care for patients with SCI.
2
Data are only as complete as the data entered by each social worker/case manager; some intervention time may not have been included.
3
Insurance information was available for the time of admission to rehabilitation but not at the time of the 1-year injury anniversary.

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