Return to work and productive activities following a spinal cord injury: the role of income and insurance

Study design: We analyzed longitudinal data on secondary outcomes from participants in a telerehabilitation study. Objectives: To examine the factors affecting return to productive activities and employment and the time to these events following a spinal cord injury (SCI). Setting: A large southeastern rehabilitation hospital in the United States. Methods: We used hazard regression models to analyze data from newly injured people (n=111) participating in an educational intervention post discharge who were followed for up to 2 years. Outcomes were time to return to productive activities and employment. Results: Increasing age and being on Medicaid significantly decreased the likelihood of returning to productive activities (P < 0.01), while being white (P < 0.05) and having a higher median income (P < 0.001) significantly increased this probability. The same factors, bar being on Medicaid, affected the return to employment. Whites returned to productive activities 2.5 times sooner than African Americans and employment twice as fast (P < 0.001). Being in the 75th income percentile compared with the 25th shortened time to employment by 209 days. Conclusion: Findings here suggest that income and race affect the time to return to productivity and employment, while being on Medicaid also has a role in general post injury productivity. Spinal Cord (2012) 50, 623-626; doi:10.1038/sc.2012.22; published online 13 March 2012