INSURANCE BENEFITS COVERAGE - DOES IT AFFECT REHABILITATION OUTCOMES

This study investigates the effect of insurance benefits coverage, pro vided by four payors of rehabilitation (i.e., Automobile No-Fault, Pri vate, Workers' Disability Compensation, Medicaid), on the rehabilitati on outcomes of 111 spinal cord injury (SCI) patients. Rehabilitation o utcomes included patient's level of activity, psychological distress a nd restrictiveness of the living situation at one year post-injury. SC I patients were classified according to initial neurological level of injury (paraplegia or quadriplegia) and to rehabilitation insurance pa yor sponsorship (catastrophic and non-catastrophic). Differences on pa tients' outcome scores were analyzed first using Student t tests for i ndependent means. Three separate multiple regression analyses were spe cified to control for the effect of extraneous variables on outcomes, and to determine the role of each variable, including payor, in predic ting outcomes. Results suggested that payor was not a strong predictor of these outcomes. Restrictiveness of the post-discharge living situa tion was best predicted by the patient's pre-injury restrictiveness of the living situation. Post-discharge psychological distress was best predicted by the extent of personal care attendant services received d uring that first year. Level of activity at one year post-injury was s trongly associated with subjects' chronological age, level of SCI, res trictiveness of current living situation, and psychological distress a t admission to inpatient rehabilitation.