CL-14: DISPARITIES IN REHAB PLACEMENT FOR VICTIMS OF VIOLENCE
Ella Cornell, BA¹, Megan Janeway, MD², Nina Jreige, BSc¹, Stephanie Talutis, MD², Lisa Allee, MSW, LICSW², Sabrina Sanchez, MD, MPH², Timothy Munzert, MSW, LCSW², Tracey Dechert, MD, FACS²; ¹Boston University School of Medicine, ²Boston Medical Center

Background: Studies have demonstrated racial and insurance disparities in access to post-hospitalization care. This study examines the independent effect of type of injury- violent versus accidental- on rehab placement

Methods: We performed a single-center retrospective study of admitted patients with traumatic injuries at our urban academic medical center during a 4-year period. We reviewed data on the admission, physical therapy and case management evaluations, discharge disposition, and the reasons for rehab rejection

Results: 2757 patient records were reviewed, and patients with violent injury (VI) (n=681) were compared to those with non-violent injury (NVI) (n=2,076). VI were significantly less likely to be placed in acute/inpatient rehab (8.1%) compared to NVI (34.1%) and in skilled nursing facilities (1.9%) compared to NVI (8.5%). VI were significantly more likely to be discharged home without services (72.1%) compared to NVI (41.2%). VI were inappropriately placed in 10.8% had delayed placement in 16.2% of admissions. Evaluation of case management notes eluded to the reason for delay and rejection being “safety concerns” and requirements for detective statements.

Conclusions: Violent injury is associated with increased likelihood of inappropriate post-hospitalization disposition. Efforts should be made to ensure victims of violence are not discriminated against during the rehab screening process.