A traumatic brain injuries, or TBI, can be devastating and have long-lasting effects. In children these injuries can be even more problematic, interfering with learning and development. A new study at the University of Washington shows that in addition to the injury, some children are not getting adequate care compared to other children and those differences fall along racial and economic lines.
The study found that less than 20 percent of rehab providers in the state accepted Medicaid and also provided translation services to children with traumatic brain injuries. Even lower was the number of providers that also offered mental health services, a shocking 8%. Families whose primary language was Spanish had to travel further to use services as well. Considering that in Washington 18% of homes speak a language other than English and over half of children under the age of 18 are on Medicaid, the problem is having a definite effect on critical care for children who have suffered a brain injury.
Study lead author Megan Moore, the Sidney Miller Endowed Assistant Professor in Direct Practice at the UW School of Social Work and a core faculty member at the UW Harborview Injury Prevention and Research Center said in a press release,“Rehabilitation after a brain injury is incredibly important, especially for kids with moderate to severe brain injuries. Ultimately, that limited availability is going to impact children’s outcomes.”
The study, which was published recently in the American Journal of Physical Medicine and Rehabilitation was conducted by University of Washington researchers who built a database of healthcare providers in the state, all of whom offered physical and occupational therapy; speech, language and cognitive therapy in the treatment of TBIs. The study team called 293 such providers and asked about the services provided, if Medicaid was accepted and what, if any, interpretation was provided for families who spoke Spanish. The results were eye-opening.
The research found that less than half of the providers surveyed would accept children who were on Medicaid. When looking at the need for language interpretation services, the team found that children who needed mental health services, PT, OT and who were enrolled in Medicaid would only be able to get those services from less than 20% of all the providers available. 100% of the providers surveyed accepted private insurance, and, of course, all were able to provide care in English.
Washington is a big state, so the study team looked at travel times as well. Using previous research on 82 children who had been treated at Harborview Medical Center, they found that Spanish speaking families had to drive an average of 16 minutes further to see a mental health provider than families who did not need interpretation services. To receive physical or occupational therapy, there was an an average of 9 minutes more travel time for these families.
Most surprising was the inverse relationship between the diversity of a county and the availability of services for brain injury care. For every 10% increase in families who did not speak English, there was a 34% decrease in services available in these locations. These results back up earlier UW research that showed Latino children have poorer outcomes after brain injuries and suggest that those outcomes could be tied to the limited availability of services. The video below explains more about the study and why it’s crucial for all children to receive adequate care after a brain injury.
Sources: University of Washington
, American Journal of Physical Medicine and Rehabilitation