A Naturalistic Study of Vocational
Rehabilitation Service Utilization
While variables that predict return to work have been studied, the effect
of receiving services from the state-federal vocational rehabilitation
system is rarely examined. There is a marked schism in TBI research
between studies based on cohorts selected from admissions to acute trauma
or medical rehabilitation units, and studies of persons receiving vocational
rehabilitation via the state-federal system. The present study sought
to bridge this schism by investigating the vocational rehabilitation experience
of a prospective sample of consecutive admissions to a specialized brain
injury rehabilitation unit. Subjects enrolled in a prospective,
longitudinal outcome study were identified in the management information
system of the state vocational rehabilitation authority, and their history
of referral, eligibility, and outcomes were extracted. Results
indicated that during the 3 to 5-year period following discharge, 47%
of subjects were referred. The average time from rehabilitation discharge
to referral was 5.6 months, the median was 2.4 months. Of the subjects
referred, 53% were found eligible. Of those eligible, 29% were eventually
closed as a successful rehabilitation; another 46% were closed unsuccessfully;
and the remaining 25% were still in process. The average total cost of
services for those closed successfully was $9,380; the average for unsuccessful
closures was $4,277. Characteristics of subjects more likely to be referred,
found eligible, and closed successfully were identified. These results
have important public policy implications for the relationship between
medical and vocational rehabilitation systems.
Suggested Readings
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