Study Reveals Low Access to Inpatient Rehabilitation for Stroke and Brain Injury Patients in the US

A recent study published in *Neurology® Open Access*, an official journal of the American Academy of Neurology, has brought to light a significant gap in healthcare access for stroke and traumatic brain injury (TBI) patients in the United States. The research indicates that less than a quarter of stroke survivors and fewer than one in seven individuals with TBI receive inpatient rehabilitation care after hospitalisation. The study, released on June 10, 2026, also uncovered concerning disparities in access based on sex, race, insurance coverage, and income levels.

The Importance of Intensive Rehabilitation

Dr. Farhaan S. Vahidy, MBBS, PhD, from TIRR Memorial Hermann in Houston, Texas, and a member of the American Academy of Neurology, emphasised the critical role of intensive rehabilitation in recovery. “Receiving intensive rehabilitation after stroke, traumatic brain injury and spinal cord injury can improve a person’s recovery, yet access to inpatient rehabilitation care remains inconsistent and may not be equitable,” stated Dr. Vahidy. He further noted that inpatient rehabilitation facilities offer more intensive care—typically over three hours daily—compared to skilled nursing facilities. The study suggests that many more individuals are eligible for this type of rehabilitation than currently receive it, with a disproportionate impact on historically marginalised communities, those with Medicaid, and residents of lower-income areas.

Study Methodology and Key Findings

Researchers reviewed four years of health records from five US states, identifying 444,908 adults hospitalised for stroke, TBI, or traumatic spinal cord injury. The average age of participants was 69. The cohort consisted of 75% stroke patients, 24% TBI patients, and 1% with spinal cord injury. Post-hospitalisation, only 22% were discharged to inpatient rehabilitation facilities, while 26% went to skilled nursing facilities, and a majority (54%) were sent home.

Specifically, only 22% of stroke patients and 14% of TBI patients were discharged to an inpatient rehabilitation facility. In contrast, 44% of those with spinal cord injuries received this level of care. These figures underscore the disparity in access for stroke and TBI patients.

Datos clave

Metric	Stroke Patients	Traumatic Brain Injury Patients
Discharged to Inpatient Rehab	22%	14%
Total Patients Studied	75%	24%

Disparities in Access

The study also delved into demographic differences in access to inpatient rehabilitation. After adjusting for factors such as insurance status, home residence, and health conditions like high blood pressure and diabetes, several patterns emerged:

• Age: Older individuals (average age 75) had a 4% higher likelihood of being discharged to an inpatient rehabilitation facility compared to younger individuals (average age 63).
• Sex: Female participants showed a 19% higher likelihood than male participants.
• Race: Black individuals had a 29% higher likelihood than white individuals, while Hispanic individuals had a 22% lower likelihood.

Further analysis revealed that having private insurance or Medicaid (versus Medicare) and residing in areas with the highest average income (compared to the lowest) were associated with a 12% lower likelihood of discharge to an institutional rehabilitation facility. When focusing solely on patients discharged to either rehabilitation or skilled nursing care, Black individuals had a 10% lower likelihood of being sent to a rehabilitation facility over a skilled nursing facility.

Implications for India and Future Research

While this study focuses on the US healthcare system, its findings resonate deeply with global challenges in healthcare access, including in India. Understanding such disparities is crucial for policymakers and healthcare providers in India, particularly as the nation confronts its own burden of neurological disorders. The insights from this research can inform strategies to improve equitable access to post-acute care, especially for vulnerable populations, aligning with the goals of initiatives like the IndiaAI Mission to leverage technology for better health outcomes.

Limitations and Path Forward

The researchers acknowledged several limitations, including the retrospective nature of the administrative data, which prevents the determination of causal relationships or accounting for unmeasured social and individual factors. The data also lacked information on the severity of strokes, TBIs, and spinal cord injuries.

Dr. Vahidy concluded, “Ensuring equitable access to intensive inpatient rehabilitation can help improve long-term outcomes for people with these conditions. Future studies should further examine differences in care and develop interventions to reduce disparities.”

Fuente: Newswise.com – https://www.newswise.com/articles/fewer-than-1-in-4-with-stroke-1-in-7-with-brain-injury-receive-inpatient-rehab/?sc=rsla