Understanding Problems in Communication and Cognition Experienced by Uninsured Individuals Following Brain and Spinal Cord Injuries 1071

Background: Uninsured individuals who experience brain and spinal cord injury may not have access to healthcare services following their injury. We describe the demographic characteristics and reported problems in communication and cognition of individuals attending the Georgia Rehabilitation Volunteer Services Partnership (RSVP) Clinic, a free clinic that provides rehabilitative care to uninsured and underinsured individuals who experience these injuries.
Design and Participants: Participants are those who attended the GA RSVP Clinic. Descriptive statistics examined at admission include injury type, age, race/ethnicity, highest level of education completed, employment status, and insurance type. 
Main Outcome Measures: Clinic participants are asked if they experience problems with having a conversation, reading, writing/typing, remembering things, paying attention, making decisions/solving problems, and the importance of addressing these areas in clinic. 


Results: Of the 63 participants, 49% had an acquired brain injury and 56% had a spinal cord injury. Individuals served in our clinic have a mean age of 38 years old, are primarily male (68%), Black or African American (75%) and were unemployed at the time of admission (98%). Fifty-seven individuals (ABI=29, SCI=30, Dual ABI and SCI = 2) responded to questions about difficulties in communication and cognition at clinic intake of which forty of those individuals identified one or more challenges in these areas. Writing/typing was the most prevalent communication complaint whereas remembering was the most frequently reported cognitive challenge. One participant  completed these questions at clinic discharge, demonstrating improvement in  communication and cognition.
Conclusion: The Georgia RSVP Clinic provides opportunity to understand uninsured adults who experience a brain or spinal cord injury. Clinic data provides insight on important patient experiences related to problems with communication and cognition. The clinic offers a unique opportunity to observe the “invisible” population of individuals who experience brain and spinal cord injuries who do not have access to resources in Georgia.