Patient Characteristics, Injury Types, and Costs Associated with Secondary Over-Triage of Isolated Cervical Spine Fractures

Wick, Joseph; Le, Hai; Wick, Katherine; Peddada, Kranti V.; Bacon, Adam; Han, Gloria; Carroll, Trevor; Swinford, Steven; Javidan, Yashar; Roberto, Rolando Figueroa; Martín, Allan; Ebinu, Julius O.; Kim, Kee; Klineberg, Eric O.

doi:10.1097/brs.0000000000004190

Cited by 7 publications

(4 citation statements)

References 21 publications

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“…At the onset of this project, the team knew that the program would realize per-patient cost savings and enhance the quality of care by ensuring orthosis availability. Other care processes outsourced to a vendor or associated with unnecessary care could experience benefits in care quality and cost savings by implementing similar quality improvement initiatives [ 33 , 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of the physical therapy–managed spinal orthoses program on cost of care in the hospital setting: a retrospective interrupted time-series study

Willey

Lenk

Waters

et al. 2022

International Journal for Quality in Health Care

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Background The physical therapy department at a level 1 trauma center identified vendor delivery delays of off-the-shelf (OTS) spinal orthoses that delayed patient mobilization. This study aimed to identify improvements in mobilization times, discharge times, and reduction in the cost of care after centralizing the management of orthoses within the therapy department. Methods The centralized management of OTS spinal orthoses included stocking three adjustable lumbosacral and thoraco-lumbosacral orthosis sizes and ensuring all personnel received training to appropriately fit the orthoses to patients. This study evaluates the impact of the centralized program by using a retrospective interrupted time-series design to compare outcomes before and after program implementation. Outcome measurements included orthosis delivery delay, time to orthosis delivery, time to mobilization by physical therapist, length of stay, and cost of care. Segmented linear regression, Wilcoxon rank-sum test, and Fisher Exact tests compared outcome measures before and after implementing the centralized program. Results The physical therapy managed program eliminated orthosis delivery delays noted during the vendor program (42 vs. 0; p < 0.001), resulting in an overall 13.97 hr. reduction in time to mobilization (p < 0.001). Program cost savings equated to $2,023.40 per patient (P < 0.001). Sub-group analysis of patients without complications and treated conservatively showed a significant reduction in length of stay (15.36 hrs.; p = 0.009) in addition to time to mobilization reductions. Conclusions The physical therapy managed program significantly improved the quality of care for patients that required a spinal orthosis by mobilizing patients as soon as possible, allowing timely discharge. The program also resulted in overall patient and hospital cost savings.

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Section: Discussionmentioning

confidence: 99%

Impact of the physical therapy–managed spinal orthoses program on cost of care in the hospital setting: a retrospective interrupted time-series study

Willey

Lenk

Waters

et al. 2022

International Journal for Quality in Health Care

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“…Researchers suggest this is because of the causes of injury, namely, traffic and sports accidents and falls [ 5 , 6 , 7 ]. Treatments for acute traumatic SCI are mostly limited to surgery involving re-stabilization of the spinal column and decompression of the spinal cord, as well as medical treatment with blood pressure augmentation, followed by rehabilitative treatments [ 8 , 9 , 10 ]. On the other hand, there is almost the same number of patients with non-traumatic SCI [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Regenerative Rehabilitation and Stem Cell Therapy Targeting Chronic Spinal Cord Injury: A Review of Preclinical Studies

Tashiro

Nakamura

2022

Cells

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Stem cell medicine has led to functional recovery in the acute-to-subacute phase of spinal cord injury (SCI), but not yet in the chronic phase, during which various molecular mechanisms drastically remodel the tissue and render it treatment-resistant. Researchers are attempting to identify effective combinatorial treatments that can overcome the refractory state of the chronically injured spinal cord. Regenerative rehabilitation, combinatorial treatment with regenerative medicine that aims to elicit synergistic effects, is being developed. Rehabilitation upon SCI in preclinical studies has recently attracted more attention because it is safe, induces neuronal plasticity involving transplanted stem cells and sensorimotor circuits, and is routinely implemented in human clinics. However, regenerative rehabilitation has not been extensively reviewed, and only a few reviews have focused on the use of physical medicine modalities for rehabilitative purposes, which might be more important in the chronic phase. Here, we summarize regenerative rehabilitation studies according to the effector, site, and mechanism. Specifically, we describe effects on transplanted cells, microstructures at and distant from the lesion, and molecular changes. To establish a treatment regimen that induces robust functional recovery upon chronic SCI, further investigations are required of combinatorial treatments incorporating stem cell therapy, regenerative rehabilitation, and medication.

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confidence: 99%

“…as the impact of injuries in other organs is minimal 27) . Due to the highly mobile nature of the cervical spine, serious injuries, such as spinal cord injuries, can occur even with low-energy forces that do not cause fractures 14,27) . Despite a small degree of damage, upper spinal cord injury due to cervical spine injury can significantly affect the neurological symptoms and functional prognosis of the patient across the whole body.…”

mentioning

confidence: 99%

Characteristics of Cervical Spine Injuries Caused by Industrial Accidents: The Experience of a Single Regional Trauma Center in South Korea

Yoon

Sim

Lyo

et al. 2023

Nerve

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Patient Characteristics, Injury Types, and Costs Associated with Secondary Over-Triage of Isolated Cervical Spine Fractures

Abstract: The manuscript submitted does not contain information about medical device(s)/drug(s).

Cited by 7 publications

References 21 publications

Impact of the physical therapy–managed spinal orthoses program on cost of care in the hospital setting: a retrospective interrupted time-series study

Impact of the physical therapy–managed spinal orthoses program on cost of care in the hospital setting: a retrospective interrupted time-series study

Regenerative Rehabilitation and Stem Cell Therapy Targeting Chronic Spinal Cord Injury: A Review of Preclinical Studies

Characteristics of Cervical Spine Injuries Caused by Industrial Accidents: The Experience of a Single Regional Trauma Center in South Korea

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