The structure of rehabilitation care for young patients with acquired brain injury: Similarities and differences among Dutch rehabilitation centres

Abstract

Abstract Introduction: Differences in care pathways/the delivery of rehabilitation care for young people with acquired brain injury (ABI) across rehabilitation centers (RCs), may lead to unwanted practice variations. Objective: Identifying potential similarities/differences regarding the care structure across RCs. Methods: In this cross-sectional study, Healthcare professionals from Dutch RCs that work with young people(<25 years) with ABI were invited to complete a 21-item questionnaire (12 yes/no& nine corresponding open-ended-questions). Questions were divided into three topics: admission/discharge criteria (n=2&2), organization of rehabilitation (n=7&5), and aftercare (n=3&2). Answers to open-ended questions were thematically analyzed/categorized. Differences across RCs were defined as an item being present/described in <75% of the RCs. Results: Rehabilitation professionals from 12 RCs participated. Similarities and differences were found regarding the structure of rehabilitation care. Concerning admission criteria(present in all RCs), “an ABI diagnosis” was seen by all RCs as an essential criterium, whereas all other admission criteria were described differently. The discharge criterium "goal-attainment" was the only criterium found in ≥75% of the RCs. Regarding the organization of rehabilitation, most RCs (≥75%) described “the presence of specialized teams”&“diagnosis-specific consultation appointments”. Differences were found, e.g., the “presence of transition-teams” for young adults (<75%). Concerning aftercare, similarities were found in the “presence of structural end-reports”&“discharge/follow-up appointments”. However, differences were seen in the “timing between discharge&follow-up”. Conclusion: Besides similarities between RCs, differences were found regarding the structure of outpatient rehabilitation. Gaining insights into differences across RCs and reducing practice variation could reinforce collaborations between RCs to harmonize/optimize care quality for young people with ABI.