{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T03:41:12Z","timestamp":1767066072359,"version":"3.48.0"},"reference-count":33,"publisher":"CSIRO Publishing","issue":"2","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"vor","delay-in-days":3410,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,4,3]]},"abstract":"\n Objective<\/jats:title>\n The aim of the present study was to investigate the perceptions of consultant surgeons, allied health clinicians and rehabilitation consultants regarding discharge destination decision making from the acute hospital following trauma.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A qualitative study was performed using individual in-depth interviews of clinicians in Victoria (Australia) between April 2013 and September 2014. Thematic analysis was used to derive important themes. Case studies provided quantitative information to enhance the information gained via interviews.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Thirteen rehabilitation consultants, eight consultant surgeons and 13 allied health clinicians were interviewed. Key themes that emerged included the importance of financial considerations as drivers of decision making and the perceived lack of involvement of medical staff in decisions regarding discharge destination following trauma. Other themes included the lack of consistency of factors thought to be important drivers of discharge and the difficulty in acting on trauma patients\u2019 requests in terms of discharge destination. Importantly, as the complexity of the patient increases in terms of acquired brain injury, the options for rehabilitation become scarcer.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The information gained in the present study highlights the large variation in discharge practises between and within clinical groups. Further consultation with stakeholders involved in the care of trauma patients, as well as government bodies involved in hospital funding, is needed to derive a more consistent approach to discharge destination decision making.<\/jats:p>\n <\/jats:sec>\n \n What is known about the topic?<\/jats:title>\n Little is known about the drivers for referral to, or acceptance at, in-patient rehabilitation following acute hospital care for traumatic injury in Victoria, Australia, including who makes these decisions of behalf of patients and how these decisions are made.<\/jats:p>\n <\/jats:sec>\n \n What does this paper add?<\/jats:title>\n This paper provides information regarding the perceptions of acute hospital consultant surgeons and allied health, as well as rehabilitation clinicians, in terms of discharge destination decision making from the acute hospital following trauma. The use of case studies further highlights differences between, and within, these specialities with regard to this decision making. This research also highlights the importance of financial considerations as drivers of decision making, and the lack of consistency of the factors thought to be important drivers of discharge between these different clinical groupings.<\/jats:p>\n <\/jats:sec>\n \n What are the implications for practitioners?<\/jats:title>\n This research shows that financial factors are significant drivers of discharge destination decision making for trauma patients. The present study highlights opportunities to engage with stakeholders (acute care, rehabilitation, administration, government and patients) to develop more consistent discharge processes that optimise the use of rehabilitation resources for those patients who could benefit from in-patient rehabilitation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1071\/ah16031","type":"journal-article","created":{"date-parts":[[2016,5,4]],"date-time":"2016-05-04T18:03:29Z","timestamp":1462385009000},"page":"192-200","source":"Crossref","is-referenced-by-count":9,"title":["Clinicians\u2019 perceptions of decision making regarding discharge from public hospitals to in-patient rehabilitation following trauma"],"prefix":"10.1071","volume":"41","author":[{"given":"Lara A.","family":"Kimmel","sequence":"first","affiliation":[{"name":"ADepartment of Epidemiology and Preventive Medicine, Monash University, Vic. 3004, Australia. Email: ere@bigpond.net.au; belinda.gabbe@monash.edu"},{"name":"BDepartment of Physiotherapy, The Alfred, Commercial Road, Prahran, Vic. 3181, Australia."},{"name":"JCorresponding author. Email: L.kimmel@alfred.org.au"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne E.","family":"Holland","sequence":"additional","affiliation":[{"name":"CSchool of Allied Health, La Trobe University, Vic. 3086, Australia. Email: A.holland@latrobe.edu.au; N.lannin@latrobe.edu.au"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha","family":"Lannin","sequence":"additional","affiliation":[{"name":"CSchool of Allied Health, La Trobe University, Vic. 3086, Australia. Email: A.holland@latrobe.edu.au; N.lannin@latrobe.edu.au"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elton R.","family":"Edwards","sequence":"additional","affiliation":[{"name":"ADepartment of Epidemiology and Preventive Medicine, Monash University, Vic. 3004, Australia. Email: ere@bigpond.net.au; belinda.gabbe@monash.edu"},{"name":"DDepartment of Orthopaedics, The Alfred, Commercial Road, Prahran, Vic. 3181, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard S.","family":"Page","sequence":"additional","affiliation":[{"name":"EDepartment of Orthopaedics, Barwon Health and St John of God, Geelong, Vic. 3220, Australia. Email: richardpage@geelongortho.com.au"},{"name":"FSchool of Medicine, Deakin University, Geelong, Vic. 3220, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Bucknill","sequence":"additional","affiliation":[{"name":"GDepartment of Orthopaedics, Royal Melbourne Hospital, Melbourne, Vic. 3050, Australia. Email: a.bucknill@mh.org.au"},{"name":"HDepartment of Surgery, The University of Melbourne, Vic. 3050, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raphael","family":"Hau","sequence":"additional","affiliation":[{"name":"IDepartment of Orthopaedics, Northern Hospital, Epping, Vic. 3076, Australia. Email: raphael.hau@hotmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Belinda J.","family":"Gabbe","sequence":"additional","affiliation":[{"name":"ADepartment of Epidemiology and Preventive Medicine, Monash University, Vic. 3004, Australia. Email: ere@bigpond.net.au; belinda.gabbe@monash.edu"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2016,5,5]]},"reference":[{"key":"2025121504300588000_R1","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1097\/BOT.0b013e3181962e29","article-title":"Predictors of moderate or severe pain 6 months after orthopaedic injury: a prospective cohort study.","volume":"23","author":"Williamson","year":"2009","journal-title":"J Orthop Trauma"},{"key":"2025121504300588000_R2","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1016\/j.injury.2006.10.026","article-title":"Long-term functional health status of severely injured patients.","volume":"38","author":"Holtslag","year":"2007","journal-title":"Injury"},{"key":"2025121504300588000_R3","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1097\/00005373-199905000-00003","article-title":"Outcome after major trauma: 12-month and 18-month follow-up results from the Trauma Recovery Project.","volume":"46","author":"Holbrook","year":"1999","journal-title":"J Trauma"},{"key":"2025121504300588000_R4","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1177\/1545968312440744","article-title":"Referral to rehabilitation after severe traumatic brain injury: results from the PariS-TBI Study.","volume":"27","author":"Jourdan","year":"2013","journal-title":"Neurorehabil Neural Repair"},{"key":"2025121504300588000_R5","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/0003-9993(94)90387-5","article-title":"Social and physical factors in the referral of people with traumatic brain injuries to rehabilitation.","volume":"75","author":"Wrigley","year":"1994","journal-title":"Arch Phys Med Rehabil"},{"key":"2025121504300588000_R6","unstructured":"Australian Trauma Registry. Available at: http:\/\/ntri.org.au\/img\/aust-trauma-registry-inaugural-report.pdf [verified 11 January 2006]."},{"key":"2025121504300588000_R7","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/j.injury.2012.10.002","article-title":"Acute costs and predictors of higher treatment costs of trauma in New South Wales, Australia.","volume":"45","author":"Curtis","year":"2014","journal-title":"Injury"},{"issue":"Suppl. 1","key":"2025121504300588000_R8","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1002\/bjs.7776","article-title":"Systematic review of multidisciplinary rehabilitation in patients with multiple trauma.","volume":"99","author":"Khan","year":"2012","journal-title":"Br J Surg"},{"key":"2025121504300588000_R9","doi-asserted-by":"publisher","first-page":"2201","DOI":"10.1016\/S0277-9536(02)00236-8","article-title":"Referral to rehabilitation following traumatic brain injury: a model for understanding inequities in access.","volume":"56","author":"Foster","year":"2003","journal-title":"Soc Sci Med"},{"key":"2025121504300588000_R10","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1097\/00004356-200106000-00003","article-title":"Selection for rehabilitation: acute care discharge patterns for stroke and orthopaedic patients.","volume":"24","author":"Unsworth","year":"2001","journal-title":"Int J Rehabil Res"},{"key":"2025121504300588000_R11","doi-asserted-by":"publisher","first-page":"1867","DOI":"10.1016\/j.socscimed.2004.02.017","article-title":"Referral to rehabilitation following traumatic brain injury: practitioners and the process of decision-making.","volume":"59","author":"Foster","year":"2004","journal-title":"Soc Sci Med"},{"key":"2025121504300588000_R12","doi-asserted-by":"publisher","first-page":"986","DOI":"10.3109\/09638281003775394","article-title":"Experience of recovery and outcome following traumatic brain injury: a metasynthesis of qualitative research.","volume":"32","author":"Levack","year":"2010","journal-title":"Disabil Rehabil"},{"key":"2025121504300588000_R13","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/1743-8462-4-3","article-title":"Determining appropriateness for rehabilitation or other subacute care: is there a role for utilisation review?","volume":"4","author":"Poulos","year":"2007","journal-title":"Aust New Zealand Health Policy"},{"key":"2025121504300588000_R14","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1016\/j.injury.2011.09.027","article-title":"Discharge destination following lower limb fracture: development of a prediction model to assist with decision making.","volume":"43","author":"Kimmel","year":"2012","journal-title":"Injury"},{"key":"2025121504300588000_R15","unstructured":"Australian Government. Australia\u2019s hospitals 2013\u201314: at a glance. Canberra: AIHW; 2015. Available at: http:\/\/www.aihw.gov.au\/publication-detail\/?id=60129551440 [verified 11 January 2016]."},{"key":"2025121504300588000_R16"},{"key":"2025121504300588000_R17"},{"key":"2025121504300588000_R18","unstructured":"Australian Government Department of Health. Guidelines for recognition of private hospital-based rehabilitation services (the guidelines). 2013 Available at: http:\/\/www.health.gov.au\/internet\/main\/publishing.nsf\/Content\/health-phicirculars2013-32a [verified 21 January 2016]."},{"key":"2025121504300588000_R19","doi-asserted-by":"publisher","first-page":"e005668","DOI":"10.1136\/bmjopen-2014-005668","article-title":"Providing effective trauma care: the potential for service provider views to enhance the quality of care (qualitative study nested within a multicentre longitudinal quantitative study).","volume":"4","author":"Beckett","year":"2014","journal-title":"BMJ Open"},{"issue":"Suppl.","key":"2025121504300588000_R20","first-page":"S17","article-title":"Casemix funding for acute hospital inpatient services in Australia.","volume":"169","author":"Duckett","year":"1998","journal-title":"Med J Aust"},{"key":"2025121504300588000_R21","unstructured":"SA Health. South Australia Statewide Rehabilitation Service Plan 2009\u20132017. Available at: http:\/\/www.sahealth.sa.gov.au\/wps\/wcm\/connect\/97db9d0042632bfebce5beb44d317729\/serviceplan09-17-clinicalnetworks-sahealth-0911.443pdf?MOD=AJPERES&CACHEID=97db9d0042632bfebce5beb44d317729."},{"key":"2025121504300588000_R22","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1097\/01.PCAMA.0000327413.01849.04","article-title":"Mitus AJ. The birth of InterQual: evidence-based decision support criteria that helped change healthcare.","volume":"13","author":"Mitus","year":"2008","journal-title":"Prof Case Manag"},{"key":"2025121504300588000_R23","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.2522\/ptj.20130413","article-title":"Validating a simple discharge planning tool following hospital admission for an isolated lower limb fracture.","volume":"94","author":"Kimmel","year":"2014","journal-title":"Phys Ther"},{"key":"2025121504300588000_R24","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1097\/TA.0b013e3181e70f90","article-title":"Quality in trauma care: improving the discharge procedure of patients by means of Lean Six Sigma.","volume":"69","author":"Niemeijer","year":"2010","journal-title":"J Trauma"},{"key":"2025121504300588000_R25","unstructured":"Australian Government. Development of nationally consistent subacute and non-acute admitted patient care data definitions and guidelines. 2013. Available at: http:\/\/www.aihw.gov.au\/WorkArrea\/DownloadAsset.aspx?id=60129543218 [verified 11 January 2016]."},{"key":"2025121504300588000_R26","unstructured":"Victorian Government. Fees and charges for acute health services in Victoria. 2016. Available at: http:\/\/health.vic.gov.au\/feesman\/fees5.htm#Acute_admitted_patients [verified 4 April 2016]."},{"key":"2025121504300588000_R27","unstructured":"Australian Bureau of Statistics. Health care delivery and financing. 2012 [updated 11 November 2015]. Available at: www.abs.gov.au\/ausstats\/abs@.nsf\/Lookup\/by%20Subject\/1301.0~2012~Main%20Features~Health%20care%20delivery%20and%20financing~235 [verified 11 January 2016]."},{"key":"2025121504300588000_R28","first-page":"333","article-title":"Justice in the allocation of public resources to disabled citizens.","volume":"69","author":"Brody","year":"1988","journal-title":"Arch Phys Med Rehabil"},{"key":"2025121504300588000_R29","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1097\/TA.0b013e31815ede46","article-title":"Inequity of rehabilitation services after traumatic injury.","volume":"66","author":"Nirula","year":"2009","journal-title":"J Trauma"},{"key":"2025121504300588000_R30","doi-asserted-by":"publisher","first-page":"149","DOI":"10.5694\/mja12.11179","article-title":"Patient perspectives of care in a regionalised trauma system: lessons from the Victorian State Trauma System.","volume":"198","author":"Gabbe","year":"2013","journal-title":"Med J Aust"},{"key":"2025121504300588000_R31","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1017\/BrImp.2013.21","article-title":"Which factors determine who is referred for community rehabilitation following traumatic brain injury?","volume":"14","author":"Ta\u2019eed","year":"2013","journal-title":"Brain Impair"},{"key":"2025121504300588000_R32","first-page":"83","article-title":"Rehabilitation of the severely brain-injured patient.","volume":"14","author":"Tobis","year":"1982","journal-title":"Scand J Rehabil Med"},{"key":"2025121504300588000_R33","doi-asserted-by":"publisher","first-page":"363","DOI":"10.3109\/02699059209034951","article-title":"Functional improvement in severe head injury after readmission for rehabilitation.","volume":"6","author":"Tuel","year":"1992","journal-title":"Brain Inj"}],"container-title":["Australian Health Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/connectsci.au\/ah\/article-pdf\/41\/2\/192\/1326733\/ah16031.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/connectsci.au\/ah\/article-pdf\/41\/2\/192\/1326733\/ah16031.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T09:30:19Z","timestamp":1765791019000},"score":1,"resource":{"primary":{"URL":"https:\/\/connectsci.au\/ah\/article\/41\/2\/192\/194418\/Clinicians-perceptions-of-decision-making"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,5,5]]},"references-count":33,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,4,3]]}},"URL":"https:\/\/doi.org\/10.1071\/ah16031","relation":{},"ISSN":["0156-5788","1449-8944"],"issn-type":[{"type":"print","value":"0156-5788"},{"type":"electronic","value":"1449-8944"}],"subject":[],"published":{"date-parts":[[2016,5,5]]}}}