Vocational rehabilitation service patterns related to successful competitive employment outcomes of persons with spinal cord injury

Objective: To examine the effect of demographic, work disincentives, and service variables on employment outcomes of persons with spinal cord injury in state vocational rehabilitation agencies. Design: An ex post facto design, using data mining as a statistical analysis strategy. Setting: State vocational rehabilitation agencies. Participants: 10,901 persons with spinal cord injury whose cases were closed either as employed (54%) or not employed (46%) by state vocational rehabilitation agencies in the fiscal year 2001. Interventions: Vocational rehabilitation services. Main Outcome Measures: Measures of employment status, demographic characteristics, work disincentives, and provision of vocational rehabilitation services were extracted from the Rehabilitation Services Administration Case Service Report database. Results: The chi-squared automatic interaction detector (CHAID) data mining analysis revealed that job placement services, work disincentives, and case expenditures as the most important predictors of employment outcomes. In addition, physical restoration, substantial counseling, and assistive technology services all led to positive employment outcomes. Importantly, the CHAID analysis segmented the sample into 45 mutually exclusive homogeneous end groups, with a wide range of employment outcomes. The CHAID analysis indicated that demographic variables interacted with rehabilitation services to affect employment outcomes. Conclusions: The results confirmed substantial counseling, assistive technology, and job placement and support services are important to the return-to-work success of persons with SCI.