Purpose: To evaluate needs of support in ensuring work readiness and facilitating reinstatement among patients with higher cognitive dysfunctions at the time of 1 year after injury, patients who returned to work, to school, and patients who were training for work readiness.
  Methods：This was a retrospective study of 100 patients（age, 17 to 59 years, 84 men and 16 women）with higher cognitive dysfunctions due to brain injury, who participated to cognitive rehabilitation in our hospi tal. Neuropsychological examinations, outcome, work readiness at the time of 1 year after injury was inves tigated. The effects of medical and social intervention in ensuring work readiness were analyzed, and out comes at 3 years were investigated.
  Results: After receiving medical rehabilitation in the hospital and social rehabilitation at the training center, 30％ of patients returned to work, and 5％ to school, at 1 year after injury. At the same time, 34％ of patients were training for work readiness in the hospitalʼs outpatientsʼ rehabilitation service and social reha bilitation training course for independent living and special career course in the vocational training center.Patients returned to work and to school showed significant higher score of Processing speed of WAIS-III, Profile of RBMT, Score of TMT A and B than patients who were training to return to work. Training patients needed more support for work readiness.
  However, at 3 years after injury, because of continuous training in work readiness, hospitalʼs outpatientsʼ rehabilitation service and social rehabilitation training course for independent living, in percentage of work ing individuals increased up to 51％. The training was achieved through collaboration between the hospital and training center.
  Conclusion: The results demonstrate that in patients with persistent substantial disability due to higher cognitive dysfunctions at 1 year after injury, interventions aimed to ensure work readiness are important and should involve both medical rehabilitation and social training. Such interventions facilitate return to work.