Low-income children receive sub-par care for brain injuries, study says

A lack of Spanish-speaking providers is part of the problem, but the amount of travel to get to facilities and variability in Medicaid acceptance makes it worse.
By Stephen Feller   |   May 23, 2016 at 4:20 PM

SEATTLE, May 23 (UPI) -- Low-income, Spanish-speaking children generally receive sub-par care after traumatic brain injuries, according to a recent study.

Researchers at the University of Washington found that even if parents can find medical providers who speak Spanish, there is wide variability in how far they have to travel and whether Medicaid will be accepted once they get there.

Traumatic brain injuries can cause long-term problems for children and require rehabilitation for months or years after an injury.

Previous studies by the same research team found Hispanic children do not receive the same care as others following traumatic brain injuries, finding access to care is strongly tied to Spanish-speaking facilities.

"It's a huge problem, and we definitely need to get everybody on board to address it, not just the advocates," Joanna Ramos, co-chair of the Washington State Coalition for Language Access, said in a press release. "Language services need to be a routine part of health care services, not a standalone thing."

For the study, published in the American Journal of Physical Medicine and Rehabilitation, researchers analyzed data on 82 children with moderate to severe traumatic brain injuries, comparing them to rehabilitation providers around the state of Washington, including availability and travel time.

Overall, children with Medicaid have fewer rehabilitation services available than people with private insurance. Just 46 percent of providers in the state accepted Medicaid, less than 20 percent of all providers accepted the government insurance and also offered language services to patients, and 8 percent of providers accepted children with Medicaid who needed language services.

Compared to English-speaking parents, Spanish-speaking parents had to drive about 16 minutes farther to reach mental health providers and had to travel an extra nine minutes to get to physical, occupational, speech or cognitive therapists, researchers reported.

On top of this, the researchers said the data may not reflect the number of patients turned away because providers have hit their limits on the number of Medicaid patients they accept.

"Rehabilitation after a brain injury is incredibly important, especially for kids with moderate to severe brain injuries," said Dr. Megan Moore, an assistant professor at the University of Washington's School of Social Work. "Ultimately, that limited availability is going to impact children's outcomes."

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