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Journal of Head Trauma Rehabilitation

Year, Volume, Issue, Page(s):

, 32, 3, 158-167

Publication Website:


Study developed a profile of individuals with traumatic brain injury (TBI) who received inpatient rehabilitation and were discharged to an institutional setting using characteristics measured at rehabilitation discharge. Data were analyzed data for participants enrolled in the Traumatic Brain Injury Model Systems National Database from January 2002 to June 2012 who had lived in a private residence before TBI. Logistic regression analyses were used to identify sociodemographic factors, lengths of stay, and cognitive and physical functioning levels that differentiated patients discharged to institutional versus private settings. The results indicated that older age, living alone before TBI, and lower levels of function at rehabilitation discharge (independence in locomotion, bladder management, comprehension, and social interaction) were significantly associated with higher institutionalization rates and provided the best models identifying factors associated with institutionalization. Institutionalization was also associated with decreased independence in bed-chair-wheelchair transfers and increased duration of posttraumatic amnesia. Research evaluating the effect of increasing post-discharge support and improving treatment effectiveness in these functional areas is recommended.


Eum, Regina S., Brown, Allen W., Watanabe, Thomas K., Zasler, Nathan D., Goldstein, Richard, Seel, Ronald T., Roth, Elliot J., Zafonte, Ross D., Glenn, Mel B.