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Patients who died had an increased sequential organ failure assessment score and need for vasopressors.

Despite having high healthcare needs, individuals with spinal cord injury (SCI) receive suboptimal primary care; they are less likely than able-bodied persons to receive preventive care and more likely to have unmet health care needs. The aim of this mixed quantitative (surveys) and qualitative (interviews) study was to gather primary care health provider and rehabilitation specialists’ perspectives on why these challenges persist despite the increasing body of evidence identifying delivery service gaps. Surveys were completed by 12 family physicians who referred individuals with SCI to an interprofessional primary care mobility clinic. Interviews were completed with eight SCI rehabilitation providers. Questions in both the survey and interviews were asked related to the barriers to the provision of optimal care for SCI, potential solutions, and preferred methods for knowledge dissemination. Skill and attitudinal reasons were offered for the lack of evidence to practice transfer including: the absence of patient self-management, poor access to specialists, lack of education for family practice physicians, fragmentation of community resources and co-ordination upon hospital discharge. Solutions offered included greater patient self-management, better access to specialists, specialized primary care services and provision of SCI guidelines and protocols. Participant explanations and solutions were then analyzed through a social disability lens to see if new understandings could be identified to explain the lack of uptake from research findings to clinical practice for this underserviced vulnerable population.

Context: Persons with spinal cord injury (SCI) experience significant challenges when they access primary care and community services. Design: A provincial summit was held to direct research, education, and innovation for primary and community care for SCI.

Differences between recipients and nonrecipients and the small number of higher risk patients confounded assessment.