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

Abstract

Objective: To investigate associations of social work/case management (SW/CM) services during inpatient rehabilitation following spinal cord injury (SCI) and patient characteristics with outcomes. Design: Prospective observational cohort of individuals with SCI receiving inpatient rehabilitation. Setting: Six inpatient rehabilitation centers. Participants: 1032 individuals with traumatic SCI. Interventions: Not applicable. Main outcome measure(s): Type of residence at the time of rehabilitation discharge. Employment/school status, presence of a pressure ulcer, Patient History Questionnaire, Satisfaction with Life Scale, Craig Handicap Assessment and Reporting Technique (CHART) subscales, and rehospitalization at 1-year post-injury. Results: The intensity of specific SW/CM services is associated with multiple outcomes examined. More sessions dedicated to discharge planning for a home discharge and financial planning were associated positively with more discharge to home, while more sessions focused on planning for discharge to a location other than home, e.g. nursing home or long-term acute care facilities, have negative associations with societal participation outcomes (CHART Social Integration, Occupation, and Mobility scores) as well as with residing at home at the time of the 1-year injury anniversary. Conclusion(s): The intensity and type of SW/CM services are associated with outcomes at rehabilitation discharge and at 1-year post-injury. Discharge to home may require assistance from SW/CM in the area of discharge planning and financial planning, while discharge to non-home residence demands directed SW/ CM services for such placement. Note: This is the eighth of nine articles of this SCIRehab series.

Does Specialized Inpatient Rehabilitation Affect Whether or Not People with Traumatic Spinal Cord Injury Return Home?

“…We focused on return to home at discharge, but other studies have shown that rehabilitation is also associated with living at home at 1-year injury anniversary, 35 as well as greater life satisfaction and societal participation, 40 return to work, and fewer rehospitalizations. 35 Rehabilitation has also been demonstrated to reduce the need of ongoing community care, resulting in savings that can offset the costs of SCI-specialized rehabilitation by 13 to 30 months post-discharge, demonstrating the cost-efficiency of rehabilitation.…”

“…We focused on return to home at discharge, but other studies have shown that rehabilitation is also associated with living at home at 1-year injury anniversary, 35 as well as greater life satisfaction and societal participation, 40 return to work, and fewer rehospitalizations. 35 Rehabilitation has also been demonstrated to reduce the need of ongoing community care, resulting in savings that can offset the costs of SCI-specialized rehabilitation by 13 to 30 months post-discharge, demonstrating the cost-efficiency of rehabilitation. 4 Given the numerous non-clinical factors that could influence returning home as discussed above and the need to balance between patient's potential gain from rehabilitation and finite resources, providing specialized rehabilitation for all patients may not be ideal or sufficient to improve likelihood of returning home, but addressing barriers specific to each situation might.…”

“…Although likely applicable to only a younger age group (<65 years old), our finding adds to a growing body of evidence demonstrating the effectiveness of rehabilitation services. 4,15,35 Although we did not delineate the specific aspects of rehabilitation services that might contribute to going home, research suggests that non-clinical factors including treatment by clinicians with more experience in SCI rehabilitation, bedside education and care management, 15 nursing, as well as planning for home discharge and financial planning as part of social work and case management 35 increase the likelihood of home discharge. These research findings highlight the complex factors influencing discharge destination in 2870 CHENG ET AL.…”

The landing is too hard: How social workers perceive institutional support for case management in services for adults with intellectual disabilities in Hong Kong

“…Internationally, literature about social work case management is not as abundant as we might imagine during the past 20 years. The focuses of this literature mainly include intervention models and experiences (Adams et al, 2014; Diwan et al, 2001; Hyduk, 2002; Liu et al, 2004), process and outcome evaluation (Hammond et al, 2012), policies related to case management (Cambridge, 2008), significant characteristics of case management in services for adults with intellectual disabilities (Bigby et al, 2002), insufficient case management content in social work education (Cooper and Roberts, 2006; Kennedy et al, 2001; Xun, 2019). These studies make conclusions regarding the nature of service users, education background of case managers, case management models, and related policies.…”

Self-Reported Dental Visits Among Older Adults Receiving Home- and Community-Based Services

“…Individuals who receive support through case management must have a needs evaluation, an identified care plan, and a service arrangement (Hammond et al, 2012;Missouri Department of Health and Senior Services, n.d.;Silva et al, 2013). For instance, case management may include a plan for rehabilitation and services necessary to transition from a hospital or assisted living institution to home placement (Hammond et al, 2012;Missouri Department of Health and Senior Services, n.d.). In our study, older adults living in rural areas and receiving case-management services were more likely to be routine dental users by having a dental visit in the last 12 months.…”