B – 66 Impact of Social Determinants of Health on Outcomes of Disorders of Consciousness Rehabilitation

Abstract Objective This study aims to evaluate the relationship between recovery in patients with a disorder of consciousness (DOC) in an acute inpatient rehabilitation (AIR) setting and social determinants of health (SDH) such as insurance payor source and length of rehabilitation stay (LOS). Method A retrospective analysis of a consecutive sample of 197 individuals seen in AIR between 2013 and 2024 was conducted. Variables of interest include age, sex, mechanism of injury, insurance payor source, mean income and poverty rate of patients’ home zip code, LOS in AIR, change in Coma Recovery Scale, Revised (CRS-R) score, and change in CRS-R diagnosis over the course of admission to AIR. CRS-R scores and diagnoses included in analyses were collected upon admission to and discharge from AIR. Results In this sample, mechanism of injury, sex, age, and neighborhood economic factors were not found to be significantly related to change in CRS-R score or change in CRS-R diagnosis. LOS was found to have a significant positive correlation of rs = 0.46 (p < .001) to change in overall CRS-R score, and also significantly increased the likelihood of positive change in CRS-R diagnosis (rs = 0.42, p < .001). There was a significant relationship between payor source and LOS X2 (3, N=197)=9.44, p=0.024, but further analyses were not significant when adjusted for multiple comparisons. Conclusion This retrospective study indicates that LOS in AIR is positively associated with improved cognitive outcome for individuals with a DoC. Payor source was found to have a significant relationship with length of stay.