ArticleJournal of the American Geriatrics Society2021
Rural/urban differences in discharge from rehabilitation in older adults with traumatic brain injury.
Article in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 13 citations in OpenAlex.
- Substance Use and Traumatic Brain Injury: Evidence from a Rural Trauma Center.International journal of environmental research and public health · 2026Observational
- Influence of social determinants of health on post-acute use and outcome: a scoping review.Health affairs scholar · 2026Review
- From bottleneck to efficiency: Key areas for improving discharge management in healthcare - a qualitative study.German medical science : GMS e-journal · 2026Article
- Review
- Correlations Between County-Level Social Determinants of Health and Traumatic Brain Injury-Related Mortality in the United States.Neurotrauma reports · 2025Article
- Use of computer simulation to identify effects on hospital census with reduction of transfers for non-procedural patients in community hospitals.BMJ open quality · 2024Article
- Reducing risks in complex care transitions in rural areas: a grounded theory.International journal of qualitative studies on health and well-being · 2023Article
- Care patterns and predictors of community residence among older patients after hospital discharge for traumatic brain injury.Journal of the American Geriatrics Society · 2023Article
- A Scoping Literature Review of Rural Institutional Elder Care.International journal of environmental research and public health · 2022Article
- Challenges and opportunities in diagnosing and managing mild traumatic brain injury in rural settings.Rural and remote health · 2022Article
- Fewer potentially avoidable health care events in rural veterans with self-directed care versus other personal care services.Journal of the American Geriatrics Society · 2022Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
BACKGROUND/
objectivesRates of traumatic brain injury (TBI) among older adults and treatment of this population in nursing homes are increasing. The objective of this study is to examine differences in the quality of care and outcomes of older adults with TBI in rural and urban settings by (1) comparing the rates of successful community discharge; and (2) reasons for not achieving successful discharge among patients in rural and urban environments.
designRetrospective national cohort study of skilled nursing facility (SNF) patients using Medicare inpatient claims linked with Minimum Data Set assessments. Demographic, health, and facility characteristics were compared between rural and urban settings using descriptive statistics. Logistic regression with state random effects was used to identify characteristics that predicted successful discharge.
settingU.S. skilled nursing facilities (n = 11,771).
participantsMedicare beneficiaries aged 66 and older discharged to a SNF following hospitalization for TBI between 2011 and 2015 (n = 61,021). MEASUREMENTS: Successful community discharge defined as discharge from SNF within 100 days of admission and remaining in the community for ≥30 days without dying or admission to an inpatient healthcare facility.
resultsUnadjusted rates of successful discharge were significantly lower for patients in rural settings compared with patients in urban settings (52.1% vs 58.5%, p < 0.01). Patients in rural settings had lower adjusted odds (odds ratio 0.84, 95% confidence interval = 0.80-0.89) of successful discharge. Reasons for not discharging successfully differed between rural and urban settings with rural patients less likely to discharge from SNF within 100 days though also less likely to be rehospitalized within 30 days of SNF discharge.
conclusionGiven the low overall rate of successful community discharge and worse outcomes among rural patients, further research to explore interventions to improve SNF care and discharge planning in this population is warranted.
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Registered trials
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