Abstract
Acquired brain injuries (ABI) – from trauma, stroke, infectious diseases, and brain tumors – are a serious
public health issue affecting individuals, families, and communities. Advances in emergency medicine and
improved acute care have significantly increased the likelihood of surviving a severe brain injury.
However, the American health care system comes up short on providing appropriate access to post-acute
rehabilitation leading to higher health care costs and reduced quality of life. The lack of access to post-acute rehabilitation after a severe brain injury limits opportunities for patients
to return to work and have better function and quality of life, increases family caregiving and economic
burdens, and strains public liabilities for long-term care. Post-acute rehabilitation is interdisciplinary –
supporting physical, cognitive, and social skills – and intensive. Access can be limited by lack of insurance,
lack of coverage or limits to coverage for rehabilitation, lack of services available close to home, and lack
of understanding of the beneficial impact of rehabilitation access. Providing appropriate post-acute
rehabilitation services benefits physical, cognitive, and emotional/behavioral function, return to work,
independence, participation in the community. Access also reduces the total cost of their health care,
particularly long-term care costs. Existing data, information, expert opinion, and patient experience
support the effectiveness of rehabilitation services at improving function after severe brain injury.