Prescribing Justice: How Pediatric Physiatrists Can Close the Disability Equity Gap

Current Physical Medicine and Rehabilitation Reports · 2025-10-17

A pediatric rehabilitation therapy audit study: A brief report

Journal of Pediatric Rehabilitation Medicine · 2025-05-15

PurposeChildren with disabilities benefit from physical, occupational, and speech therapy, but families identify unmet needs for these services. The purpose of this study was to audit access to therapy services in a tri-state region. It was hypothesized that children who were publicly insured and children from minoritized identity groups would face greater access barriers and longer wait times than children covered by private insurance and non-minoritized White children.MethodsThis prospective audit study utilized callers who posed as mothers seeking outpatient therapy services for their child. Access difficulties were identified based on the number of phone calls required to obtain an appointment or determine if services would be obtained at all, as well as the number of days to the earliest available appointment.ResultsTherapy appointment access was a problem for 47.4% of simulated families. After 251 phone calls, 91 simulated families were able to schedule appointments in 76 clinics. Black and Hispanic simulated families had a harder time getting appointments, but days to appointment did not differ by telegraphed minoritized identity (F(3,88) = 1.474, p = .227).ConclusionSimulated families experienced substantial barriers to arranging therapy appointments with Black and Hispanic families experiencing more barriers than their White and Muslim peers.

Preferences for Chronic Pain Treatment Among American Indian and Alaska Natives

Journal of Pain · 2024-04-01

Identifying Common Data Elements to Achieve Injury-related Health Equity Across the Lifespan: A Consensus-Driven Approach

Health Equity · 2024-04-01

Background: Limited availability and poor quality of data in medical records and trauma registries impede progress to achieve injury-related health equity across the lifespan. Methods: We used a Nominal Group Technique (NGT) in-person workgroup and a national web-based Delphi process to identify common data elements (CDE) that should be collected. Results: The 12 participants in the NGT workgroup and 23 participants in the national Delphi process identified 10 equity-related CDE and guiding lessons for research on collection of these data. Conclusions: These high-priority CDE define a detailed, equity-oriented approach to guide research to achieve injury-related health equity across the lifespan.

HTA323 Understanding the Pricing and Reimbursement Outcomes of Advanced Therapy Medicinal Products (ATMP) in Spain

Value in Health · 2024-12-01

The role of social determinants of health in the receipt of school services after traumatic brain injury: A focus review on underserved pediatric populations

Neurorehabilitation · 2023-04-25 · 4 citations

BACKGROUND: Return to school is key for community re-integration after a traumatic brain injury (TBI). School support facilitates and ensure a successful transition back to school. However, access to school services is not uniform among U.S. children. OBJECTIVE: To describe school services for children with TBI from minoritized backgrounds and highlight population-specific risk factors and facilitators for accessing services. METHODS: Narrative review of the literature including studies on return to school after a mild-complicated, moderate, or severe TBI, among children enrolled in the U.S. school system. We describe receipt of services, enabling and risk factors, and outcomes, for minority children. RESULTS: There is a gap in knowledge regarding return to school among minoritized children with TBIs. Studies have few participants from racial and ethnic minority backgrounds, or low income or rural communities. Transgender and non-binary youth are not represented in present research efforts. Studies highlight larger barriers to receipt of school services among minority children and additional barriers associated with their minority status. CONCLUSION: Diversity in the U.S pediatric population is increasing. Minoritized populations are at increased risk for TBI and poor outcomes. Research focused on the needs of these populations is required to optimize school return after TBI hospitalization and overall post-discharge care.

Inpatient rehabilitation admission for a patient with spinal muscular atrophy status post gene therapy

PM&R · 2023-01-19 · 3 citations

Person-and caregiver-centered care. Qualitative study in an elderly patient with cancer

Journal of Geriatric Oncology · 2023-11-01

Using Billing Codes to Create a Pediatric Functional Status e-Score for Children Receiving Inpatient Rehabilitation

Archives of Physical Medicine and Rehabilitation · 2023-04-17

OBJECTIVE: Provide proof-of-concept for development of a Pediatric Functional Status eScore (PFSeS). Demonstrate that expert clinicians rank billing codes as relevant to patient functional status and identify the domains that codes inform in a way that reliably matches analytical modeling. DESIGN: Retrospective chart review, modified Delphi, and nominal group techniques. SETTING: Large, urban, quaternary care children's hospital in the Midwestern United States. PARTICIPANTS: Data from 1955 unique patients and 2029 hospital admissions (2000-2020); 12 expert consultants representing the continuum of rehabilitation care reviewed 2893 codes (procedural, diagnostic, pharmaceutical, durable medical equipment). MAIN OUTCOME MEASURES: Consensus voting to determine whether codes were associated with functional status at discharge and, if so, what domains they informed (self-care, mobility, cognition/ communication). RESULTS: The top 250 and 500 codes identified by statistical modeling were mostly composed of codes selected by the consultant panel (78%-80% of the top 250 and 71%-78% of the top 500). The results provide evidence that clinical experts' selection of functionally meaningful codes corresponds with codes selected by statistical modeling as most strongly associated with WeeFIM domain scores. The top 5 codes most strongly related to functional independence ratings from a domain-specific assessment indicate clinically sensible relationships, further supporting the use of billing data in modeling to create a PFSeS. CONCLUSIONS: Development of a PFSeS that is predicated on billing data would improve researchers' ability to assess the functional status of children who receive inpatient rehabilitation care for a neurologic injury or illness. An expert clinician panel, representing the spectrum of medical and rehabilitative care, indicated that proposed statistical modeling identifies relevant codes mapped to 3 important domains: self-care, mobility, and cognition/communication.