Postacute Care Setting Is Associated With Employment After Burn Injury

Arch Phys Med Rehabil. 2019 Nov;100(11):2015-2021. doi: 10.1016/j.apmr.2019.06.007. Epub 2019 Jul 3.


Objective: To examine differences in long-term employment outcomes in the postacute care setting.

Design: Retrospective review of the prospectively collected Burn Model System National Database.

Setting and participants: A total of 695 adult survivors of burn injury enrolled between May 1994 and June 2016 who required postacute care at a Burn Model System center following acute care discharge were included. Participants were divided into 2 groups based on acute care discharge disposition. Those who received postacute care at an inpatient rehabilitation facility (IRF) following acute care were included in the IRF group (N=447), and those who were treated at a skilled nursing facility, long-term care hospital, or other extended-care facility following acute care were included in the Other Rehab group (N=248).

Interventions: Not applicable.

Main outcome measures: Employment status at 12 months postinjury. Propensity score matching and logistic regression were utilized to determine the effect of postacute care setting on employment status.

Results: Individuals in the IRF group had larger burns and were more likely to have an inhalation injury and to undergo amputation. At 12 months postinjury, the IRF group had over 9 times increased odds of being employed compared to the Other Rehab group, using propensity score matching (P=.046).

Conclusions: While admitting patients with more severe injuries, IRFs provided a long-term benefit for survivors of burn injury in terms of regaining employment. Given the current lack of evidence-based guidelines on postacute care decisions, the results of this study shed light on the potential benefits of the intensive services provided at IRFs in this population.

Keywords: Employment; Postacute care; Rehabilitation; Skilled nursing facilities.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Burns / rehabilitation*
  • Employment / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Discharge / statistics & numerical data
  • Rehabilitation Centers / organization & administration*
  • Rehabilitation Centers / statistics & numerical data*
  • Retrospective Studies
  • Skilled Nursing Facilities / organization & administration
  • Skilled Nursing Facilities / statistics & numerical data
  • Socioeconomic Factors
  • Subacute Care / organization & administration*
  • Trauma Severity Indices