Enhancing Transitions From Rehabilitation Patient to Wellness Participant for People With Disabilities: An Opportunity for Hospital Community Benefit

Abstract

Pressure is increasing on not-for-profit hospitals to demonstrate that they provide sufficient benefit to the community to justify their tax-exempt status. Many industry observers have suggested that this community benefit should address unmet medical needs within the community, deficits in the social determinants of health, or health disparities within communities. We argue that one area of clear unmet need is assistance in helping bridge the transition that people with disabilities (PWD) must make from rehabilitation patient to wellness participant. Programs to bridge this transition are necessary because many PWD struggle to identify strategies to maintain and maximize their own well-being after discharge from the healthcare system. As a result, PWD have worse health outcomes than non-disabled individuals. To address these needs, we propose hospitals take a leading role in establishing new, community-based efforts to provide PWD with benefits that will support their effort to self-manage health. Hospitals are well-suited to lead the creation of these programs because of the important role they play in providing services to PWD and because of their ability to bring together multiple stakeholders required to make supportive programs sustainable.

Participatory co-creation of an adapted physical activity program for adults with moderate-to-severe traumatic brain injury

“…Based on the findings about the perceived social outcomes, it was apparent that participants felt comfortable in their social environment. This is important because community-based programs have been proposed as the logical transition from the rehabilitation continuum for people living with disabilities ( 38 ) and few studies have examined the specific effect that an individual's environment (e.g., social network members) can have on activity resumption ( 39 ). Our participants further discussed “inclusivity” and “solidarity” in the second and third phases, in addition to making good friends and planning outside activities with other members of the YMCA.…”

Retrospective evaluation of a pilot eHealth/mHealth telewellness program for people with disabilities: Mindfulness, Exercise, and Nutrition To Optimize Resilience (MENTOR)

“…In the United States, the current system for funding quality healthcare for people with disabilities is fundamentally broken (1,2). Working-age adults with disabilities visit their healthcare provider and the emergency department more frequently than people without disability (3), and individuals with mobility disability-both recently acquired and existing for many years-are seldom exposed to wellness programs that focus on improving their quality of life using adaptations where necessary to accommodate their level of health and function (4). To be clear, this does not incriminate healthcare providers as uninterested or apathetic about promoting wellness; on the contrary, many healthcare providers would welcome spending more time with patients were it not for the strong demands from health insurance providers to ensure that company profits are maintained or increased by seeing more versus less patients daily.…”

Qualitative Evaluation of a Comprehensive Online Wellness Program (MENTOR) Among People With Spinal Cord Injury

“…The connection between healthcare and wellness is typically not available in conventional healthcare systems in the United States and most other parts of the world ( 1 ). With reference to the U.S., we have yet to address the societal responsibilities and barriers that prevent individuals with spinal cord injury (SCI) from leading healthy, active lives.…”

“…Simply put, we have not achieved health equity. Working-age adults with SCI visit their healthcare provider and the emergency department more frequently than people without disability (2), and individuals with SCI-both recently acquired and existing for many years-are seldom exposed to wellness programs that focus on improving their quality of life and helping them prevent or manage physical and psychosocial secondary health conditions (1). The secondary conditions associated with disability, overlapping the natural course of aging, can bring an onset of new medical issues across an individual's lifespan (3)(4)(5)(6).…”