Health care utilization in persons with spinal cord injury: part 1—outpatient services

Gemperli, Armin; Ronca, Elias; Scheel‐Sailer, Anke; Koch, Hans Georg; Brach, Mirjam; Trezzini, Bruno

doi:10.1038/sc.2017.44

Cited by 35 publications

(57 citation statements)

References 20 publications

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“…The current findings reinforce previously reported barriers for people with SCI such as inadequate transport systems and limited local community infrastructure 6,7 ; inflexible, inadequate and inappropriately skilled personal care 6,8 ; limited generalist services combined with geographically distant specialist services 9‐11 ; as well as restricted and inflexible GP services and allied health services 12‐14 . Participants voiced the need for councils, personal care agencies, transport providers and health care systems to make changes to reduce these challenges yet recognised the economic pressures preventing such change.…”

Section: Discussionsupporting

confidence: 81%

Returning to rural communities following transitional rehabilitation after spinal cord injury

Kendall

Harre

Schuurs

et al. 2021

Australian J Rural Health

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Section: Discussionsupporting

confidence: 81%

Returning to rural communities following transitional rehabilitation after spinal cord injury

Kendall

Harre

Schuurs

et al. 2021

Australian J Rural Health

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“…This is especially important for countries with poorly developed or fragmented rehabilitation systems. As individuals with SCI are frequent users of rehabilitation and other health services, 28,29 they will be more directly impacted by difference in the performance of health systems. As more fully discussed in an article in this issue, "Comparison of the Social Response to Functioning Needs of People With SCI Across Over 20 Countries," InSCI data can provide evidence for standard socioeconomic indicators that can serve as performance indicators of health systems, as applied to persons with SCI.…”

Section: Main Outcomesmentioning

confidence: 99%

The International Spinal Cord Injury Survey: The Way Forward

Bickenbach

Batistella

Gütenbrunner

et al. 2020

Archives of Physical Medicine and Rehabilitation

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As a community survey of individuals living with spinal cord injury in 22 countries, representing all 6 of the World Health Organization regions, the International Spinal Cord Injury (InSCI) community survey is one of the few surveys that highlights not only basic medical issues, but also the impact of spinal cord injury (SCI) on the everyday lives of people. The InSCI survey is part of a much larger project known as the Learning Health System for SCI Initiative (LHS-SCI). The objective of this article is to highlight some of the ongoing and planned next steps at the national and international levels. The implementation phase of the LHS-SCI initiative, beginning with the publication of primary results and extending until 2023, will use the results of the InSCI survey as evidence for implementation of recommendations for improving the societal response to the needs of individuals with SCI at the national level. To illustrate the variety of implementation activities currently underway, we provide country examples from Australia, Morocco, Malaysia, and Germany to demonstrate the diversity of approaches to the implementation of InSCI data. The implementation phase of the LHS-SCI initiative promises to usher in a new era of SCI research that will be seamlessly linked to ongoing and effective implementation actions, at both international and national levels and across settings from clinical practice, health systems management, and national policy.

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“…Good access to appropriate health care seems to play such an important role in the lives of people with SCI that they are willing to choose their residential location based on the availability of appropriate health care. This is interesting, particularly since the health care supply in Switzerland is generally high and a doctor is never really far away regardless of where a person lives (4.0 physicians per 1000 residents; 99.8% of the population reaches a general hospital by car within 30 min, 94.0% within 15 min; 75% reach a specialized SCI center within 75 min) [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Besides living close to highly specialized SCI centers, it also seems important to people with SCI to have a wide array of outpatient services nearby. People with SCI rely on various outpatient services [ 28 ] which they use much more frequently than the general population [ 34 , 35 ]. The current study has demonstrated a positive correlation between the density of outpatient physicians practicing in a region and the propensity of people with SCI to live there.…”

Section: Discussionmentioning

confidence: 99%

Residential location of people with chronic spinal cord injury: the importance of local health care infrastructure

Ronca

Brunkert

Koch

et al. 2018

BMC Health Serv Res

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BackgroundPeople with spinal cord injury (SCI) suffer from complex secondary health conditions and rely on specialized health care services, which are often centralized and difficult to reach for individuals living in remote areas. As a consequence, they might move to regions where they expect better access to care. The aims of this study were: 1) to identify regions where people with SCI live compared with the general population, 2) to examine whether their choice of residence is related to the availability of local health care infrastructure, and 3) to ascertain determinants of their consideration to change residence when aging.MethodsThis study used information from a nationwide Swiss SCI cohort and inpatient hospital discharge data. To detect clusters in the distribution of people with chronic SCI in Switzerland, a spatial cluster detection test was conducted using the normative population of a region as offset. To identify associations between the residential location of people with SCI and infrastructure variables, a negative binomial model was set up at a regional level with the frequency of people with SCI as outcome, geographical indicators as explanatory variables, and the normative population as offset. Determinants of the consideration to change residence when aging were investigated using logistic regression models.ResultsPeople with SCI were not living equally distributed among the normative population, but clustered in specific areas. They were more likely than the general population to reside close to specialized SCI centers, in areas with a high density of outpatient physicians, and in urban regions. People with SCI living in rural areas were more likely to consider relocating when aging than those living in urban areas. However, only a few people with SCI considered moving closer to specialized centers when such a move required crossing language barriers.ConclusionsGood access to appropriate health care services and amenities of daily life seems to play such an important role in the lives of people with SCI that they are willing to choose their residential location based on local availability of appropriate health care services.

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Health care utilization in persons with spinal cord injury: part 1—outpatient services

Cited by 35 publications

References 20 publications

Returning to rural communities following transitional rehabilitation after spinal cord injury

Returning to rural communities following transitional rehabilitation after spinal cord injury

The International Spinal Cord Injury Survey: The Way Forward

Residential location of people with chronic spinal cord injury: the importance of local health care infrastructure

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