Transfer practices during acquired brain injury rehabilitation: a descent in the medical hierarchy

This chapter explores the role of healthcare organizations and their professionals in producing and reproducing inequality in health. Ethnographic fieldwork and interviews were conducted with key professionals involved in transferring patients with acquired brain injury from acute to subacute, and from subacute to stable rehabilitation. Our analytical framework combines Bourdieu’s theory of practice with Abbott’s concepts of jurisdiction. The study revealed a descent in specialization level and financial resources during patient trajectories, as well as changing patterns of decision-making practices affecting transfer. Paradoxically, many resources are available to save patients’ lives during the acute stage, but resources dwindle as the patient approaches long-term rehabilitation, thus perpetuating inequality in healthcare.