Developing quality of care indicators for patients with traumatic and non-traumatic spinal cord injury (SCI): A feasibility study using administrative health data

Abstract

Objectives: (1) to inform the development of health system quality indicators for traumatic and non-traumatic spinal cord injury from acute care admission to community care discharge using administrative data, and (2) to examine characteristics and differences in care among type of care facility, and type of pathology using administrative data. Design: Retrospective cohort study using administrative health data. Setting: Ontario, Canada. Participants: Using administrative health data, we used International Classification codes 10 th version Canadian Edition to identify incident cases of SCI from April 1, 2006 to March 31, 2012. Results: We identified 7,693 cases in our cohort, of whom 1,537 (20.0%) were categorized as traumatic spinal cord (TSCI) and 6,156 (80.0%) as non-traumatic (NTSCI). Of those identified with NTSCI, more than half (54.0%) were diagnosed with either Guillain Barré syndrome and Multiple Sclerosis (n = 3,326). More individuals admitted to a trauma/spine center were seen by an orthopedic surgeon or a neurosurgeon (20.3% compared to 5.6% for NTSCI; 77.7% compared to 24.9% for TSCI). Only 25.7% (n = 724) of the NTSCI cohort were admitted to a rehabilitation facility from a trauma/spine center, compared to 58.9% (n = 754) of those with TSCI. Conclusions: Important challenges in data completeness and utility were identified. Province wide processes to flag incomplete data and provision of incentives for comprehensive data are urgently needed to develop quality indicators across the care continuum. Consensus on the coding for NTSCI for the purposes of developing health system indicators is required.

Trends, Challenges, and Opportunities Regarding Research in Non-traumatic Spinal Cord Dysfunction

“…21 Subsequently, retrospective and prospective studies have been published with larger sample sizes, in crosssectional as well as longitudinal studies; however these were also from single centers. [22][23][24][25] Lately, multicenter studies have emerged, from both within a single country [26][27][28][29][30][31][32] and internationally. 5,33,34 Until recently, studies described the etiologies of SCDys using different classification systems, with the authors formulating their own classification systems due to the lack of an internationally accepted consensus classification system for SCDys.…”

The experiences of social and community participation of people with non‐traumatic spinal cord injury

“…However, Barclay, Lentin, McDonald and Bourke‐Taylor () identified that there are few studies that have explored the return to social and community participation following non‐traumatic spinal cord injury (Barclay et al .). Non‐traumatic spinal cord injury (NTSCI) is defined as damage to the spinal cord due to pathology such as spinal cord myelopathy, infection or transverse myelitis (Guilcher, Parsons, Craven, Jaglal & Verrier, ). Incidence of NTSCI in Australia and other developed countries has not been consistently recorded partly due to the fragmented way in which people with NTSCI receive rehabilitation services (New, ), and also due to the lack of standardised International Classification Diagnostic (ICD) codes for people with NSTCI (Guilcher et al .).…”

“…Non‐traumatic spinal cord injury (NTSCI) is defined as damage to the spinal cord due to pathology such as spinal cord myelopathy, infection or transverse myelitis (Guilcher, Parsons, Craven, Jaglal & Verrier, ). Incidence of NTSCI in Australia and other developed countries has not been consistently recorded partly due to the fragmented way in which people with NTSCI receive rehabilitation services (New, ), and also due to the lack of standardised International Classification Diagnostic (ICD) codes for people with NSTCI (Guilcher et al .). However, recent data shows that NTSCI is increasing in developed countries representing more than 50% of all those living with acquired SCI (Noreau, Noonan, Cobb, Leblond & Dumont, ).…”

Development of management of emergency surgical care for patients with acute traumatic and nontraumatic spinal pathologies in conditions of megapolis

“…Недостаточная научная освещенность свойственна многим клиническим и организационным аспектам обсуждаемой проблемы, поэтому именно в сфере организации оказания неотложной специализированной медицинской помощи вертебрологическим пациентам нехватка научной информации делает принятие эффективных управленческих решений крайне затруднительным [3,5]. Так, например, отличительной особенностью таких больных является необходимость проведения высокотехнологичных диагностических процедур в неотложном порядке [2].…”