ABSTRACT. Wehman P, Kregel J, Keyser-Marcus L, Sherron-Targett P, Campbell L, West M, Cifu DX. Supported employment for persons with traumatic brain injury: a preliminary investigation of long-term follow-up costs and program efficiency. Arch Phys Med Rehabil 2003;84:192-6. Objective: To investigate the long-term follow-up costs of supported employment as well as the wage and employment characteristics for individuals with moderate to severe traumatic brain injury (TBI) who participated in supported employment services over a 14-year time period.Design: Longitudinal design with prospectively collected data.Setting: A university-based supported employment program that uses the individual placement model of supported employment.Participants: Fifty-nine individuals with moderate to severe TBI who were consecutively referred for supported employment services. The sample was restricted to individuals who were placed into a least 1 supported employment position during the study period.Interventions: Not applicable. Main Outcome Measures: Data were collected on clients placed into at least 1 competitive supported employment position from 1985 to 1999. Analyses were performed to examine the costs of supported employment, employment characteristics (eg, wages, length of employment), and benefit-cost ratios of supported employment for individuals with TBI.Results: The average length of employment for the current sample was 42.58 months. Average gross earnings were $26,129.74 for individuals during their entire duration of employment. Billing charges accrued for employment services averaged $10,349.37. Individuals with TBI earned an average of $17,515 more than the costs associated with their supported employment.Conclusions: Our investigation provides additional support for the conclusion that supported employment is cost effective for individuals with disabilities, including individuals with TBI, and that the costs of supported employment decrease over time.
The following three themes emerged from this analysis: (1) more comprehensive provider training about spinal cord injury is needed; (2) increased communication between consumer and family would be beneficial; and (3) an increase in the flexibility and availability of services would help to ensure access to essential care.
Here are some startling facts about traumatic brain injury (TBI): • More than 1 million U.S. children are identified each year with TBI.62 ■ COUNCIL FOR EXCEPTIONAL CHILDREN
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