Objective: To determine variations in care provided by 9 inpatient rehabilitation units for children with traumatic brain injury (TBI) using newly developed quality indicators.
Design: Retrospective cohort study.
Setting: Nine inpatient rehabilitation units.
Participants: Children (N=174; age range, 0-17y) admitted for the inpatient rehabilitation of moderate to severe TBI.
Interventions: Not applicable.
Main Outcome Measures: Adherence to 119 newly developed quality-of-care indicators in 7 different domains: general care, family-centered care, cognitive-communication, motor, neuropsychological, school, and community integration.
Results: There was substantial variation both within and between institutions in the percentage of patients receiving recommended care in the 7 domains. The lowest scores were found for the school domain. Only 5 institutions scored above 50% for all quality indicators, and only 1 institution scored above 70% overall. Greater adherence to quality indicators was found for facilities with a higher proportion of therapists with pediatric training and for facilities that only admitted children. Patient volume was not associated with adherence to quality indicators.
Conclusions: The results indicate a tremendous variability and opportunity for improvement in the care of children with TBI.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3408840 | PMC |
| http://dx.doi.org/10.1016/j.apmr.2012.02.031 | DOI Listing |
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