Few people who’ve suffered a stroke or brain injury are being offered top-quality, hospital-based intensive rehabilitation, a new study says.
Only about 22 percent of patients who’ve suffered a stroke, brain injury, or spinal cord injury are sent to inpatient rehabilitation following their hospitalization, researchers reported June 10 in the journal Neurology Open Access.
That includes fewer than 1 in 4 stroke patients and 1 in 7 patients with a brain injury, researchers said.
“Inpatient rehabilitation facilities provide more intensive rehabilitation care, usually more than three hours per day, than skilled nursing facilities,” said senior researcher Dr. Farhaan Vahidy, associate vice president of research at Memorial Hermann in Houston.
“Receiving intensive rehabilitation after stroke, traumatic brain injury, and spinal cord injury can improve a person’s recovery, yet access to inpatient rehabilitation care remains inconsistent and may not be equitable,” he said in a news release.
For the new study, researchers reviewed health records from 2016 to 2019 in five states — Florida, Georgia, Maryland, New York, and Washington.
The team identified nearly 445,000 adults hospitalized for stroke, brain injury, or spinal cord injury. Of the patients, 75 percent had a stroke, 24 percent had a brain injury, and 1 percent had a spinal cord injury.
Results showed that 22 percent were sent to inpatient rehab following their initial hospitalization, 26 percent went to a skilled nursing facility, and 54 percent were sent home.
Overall, only 22 percent of those with stroke and 14 percent of those with brain injury went to inpatient rehab, compared to 44 percent of those with a spinal cord injury.
Researchers also found some disparities among the groups offered inpatient rehab.
Older people around 75 were 4 percent more likely to go to inpatient rehab than home compared to those with an average age of 63, researchers found.
Women had 19 percent higher odds of inpatient rehab than men, and Black people had 29 percent higher odds than white people, researchers found.
However, Black people had 10 percent lower odds of being sent to inpatient rehab versus a nursing facility when excluding everyone who was sent home, the study said.
Results also showed that having private insurance rather than Medicare was associated with 35 percent lower odds of inpatient rehab, and living in a high-income ZIP code was associated with 12 percent lower odds than living in a lower-income ZIP code.
“Ensuring equitable access to intensive inpatient rehabilitation can help improve long-term outcomes for people with these conditions,” Vahidy said. “Future studies should further examine differences in care and develop interventions to reduce disparities.”
Research shows that Black Americans experience higher stroke incidence, earlier stroke onset, and greater stroke-related disability than many other populations. Because intensive rehabilitation is strongly associated with better recovery outcomes, ensuring equitable access to inpatient rehabilitation may play a significant role in reducing long-term disability and functional decline. The study’s findings suggest that where patients are discharged after hospitalization may have significant implications for recovery trajectories.
The study reinforces that discharge planning is more than a logistical step — it’s a critical part of neurological rehabilitation. Clinicians caring for stroke survivors should consider whether patients — particularly those from marginalized communities — have equitable access to intensive rehabilitation services and whether social or systemic barriers could influence post-acute care placement. Early, high-intensity rehabilitation may improve functional outcomes and long-term quality of life.
More information
The University of Rochester Medicine has more on inpatient rehabilitation.
SOURCES: American Academy of Neurology, news release, June 10, 2026; Neurology Open
Access, June 2026
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