Primary care for persons with spinal cord injury — not a novel idea but still under-developed

Ho, Chester

doi:10.1080/10790268.2016.1182696

Cited by 19 publications

(32 citation statements)

References 6 publications

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“…Lack of physical access, inadequate space and the unavailability of specialized equipment may further hinder individuals with SCI from seeking care from their GP, and this may consequently in uence their choice of rst contact [8,28]. In addition, personal preferences for specialized care, familiarity with specialized rehabilitation centres for SCI, long-term relationship with SCI specialists, coordinated interdisciplinary care, and the availability of resources and information relating to one's health condition may inform the choice of rst contact [4,26].…”

Section: Interpretation and Comparison With Existing Literaturementioning

confidence: 99%

“…3 SSS is the subjective social status based on MacArthur Scale classi cation. 4 Travel distance is the distance by motor vehicle. SCI-SCS score: Spinal cord injury secondary conditions scale score.…”

Section: Fundingmentioning

confidence: 99%

“…Chronic spinal cord injury (SCI) is a complex medical condition [1], as affected individuals experience limitations in their sensory, motor, and autonomic functions that put them at high risk of developing lifethreatening complications [2]. Hence, persons with SCI require a rst contact of care who can address their acute and chronic medical problems, as well as lifestyle problems [3,4]. Primary care is recognized as the rst point of entry into the health-care system [5].…”

Section: Introductionmentioning

confidence: 99%

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First Contact of Care for Persons With Spinal Cord Injury: A General Practitioner or a Spinal Cord Injury Specialist?

Touhami

Brach

Essig

et al. 2021

Preprint

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Background. Inter-professional collaboration between general practitioners (GPs) and spinal cord injury (SCI) specialists is needed to improve the health outcomes of persons with SCI. The objective of this study is to understand the differences in long-term care provision by GPs and SCI-specialists, by examining (1) the first contact of care for SCI health problems, (2) the morbidity profile and use of health-care services in relation to first contact, and (3) the factors associated with the choice of first contact.Methods. In this cross-sectional study based on data derived from the Swiss Spinal Cord Injury Cohort Study Community Survey 2017, the main outcome measure was the reported first contact for SCI-specific care. This information was analysed using the chi-square test and logistic regression analysis of groups based on patient characteristics, use of health-care services and secondary health conditions assessed using the Spinal Cord Injury Secondary Conditions Scale (SCI-SCS). Results. Out of 1294 respondents, 1095 reported their first contact for SCI-specific care; 56% indicated SCI-specialists and 44% specified GPs. The mean ± standard deviation of the total SCI-SCS was significantly lower in persons who initially consulted GPs (13.1±7.7) than SCI-specialists (14.6±7.3). On average, participants who first contacted a GP reported higher number of GP consultations (5.1±5.2 vs. 3.9±7.2), planned visits to ambulatory clinics (3.7±7.3 vs. 3.6±6.7) and hospital admissions (GP, 1.9±1.7 vs. 1.5±1.3), but lower number of hospital days (22.8±43.2 vs. 31.0±42.8). The likelihood to contact a GP first was significantly higher in persons ≥75 years old (OR= 4.78, 95%-CI= 1.99–11.50), Italian speakers (OR= 5.11, 95%-CI= 2.47–10.54), had incomplete lesions (OR 2.51, 95%-CI 1.78–3.54) or diabetes mellitus (OR= 1.81, 95%-CI= 1.03–3.18), but lower for those situated closer to SCI centers (OR= 0.69, 95%-CI= 0.51–0.93) or experiencing bowel dysfunction (OR= 0.71, 95%-CI= 0.52–0.98).Conclusion. The choice of first contact for SCI-specific care may be partly explained by the complementary roles of GPs and SCI specialists, but the reasons for variation are still unclear. Developing a transparent shared-care model between GPs and SCI specialists, with defined roles and responsibilities, may improve the management of secondary health conditions.

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Section: Interpretation and Comparison With Existing Literaturementioning

confidence: 99%

Section: Fundingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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First Contact of Care for Persons With Spinal Cord Injury: A General Practitioner or a Spinal Cord Injury Specialist?

Touhami

Brach

Essig

et al. 2021

Preprint

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“…The special needs often lead to inadequate treatment of their health issues and secondary complications, fewer preventive screenings, and less general health promotion. 5,7 This article aims to describe and advocate for standardized care plans and address barriers that limit quality primary care for SCI patients.…”

Section: Case Reportmentioning

confidence: 99%

A Primary Care Provider’s Guide to Accessibility After Spinal Cord Injury

Lee

Varghese

Brooks

et al. 2020

Topics in Spinal Cord Injury Rehabilitation

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Individuals with spinal cord injury (SCI) continue to have shorter life expectancies, limited ability to receive basic health care, and unmet care needs when compared to the general population. Primary preventive health care services remain underutilized, contributing to an increased risk of secondary complications. Three broad themes have been identified that limit primary care providers (PCPs) in providing good quality care: physical barriers; attitudes, knowledge, and expertise; and systemic barriers. Making significant physical alterations in every primary care clinic is not realistic, but solutions such as seeking out community partnerships that offer accessibility or transportation and scheduling appointments around an individual’s needs can mitigate some access issues. Resources that improve provider and staff disability literacy and communication skills should be emphasized. PCPs should also seek out easily accessible practice tools (SCI-specific toolkit, manuals, modules, quick reference guides, and other educational materials) to address any knowledge gaps. From a systemic perspective, it is important to recognize community SCI resources and develop collaboration between primary, secondary, and tertiary care services that can benefit SCI patients. Providers can address some of these barriers that lead to inequitable health care practices and in turn provide good quality, patient-centered care for such vulnerable groups. This article serves to assist PCPs in identifying the challenges of providing equitable care to SCI individuals.

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“…continuity of care to persons with SCI, especially in conjunction with the SCI specialists. 68 Therefore, the integration of primary care in SCI models of care should be considered and a recent Canadian summit outlined plans to advance primary and community care following SCI. 69…”

mentioning

confidence: 99%

Models of Care Delivery from Rehabilitation to Community for Spinal Cord Injury: A Scoping Review

Atchison

Noonan

et al. 2021

Journal of Neurotrauma

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Spinal cord injury (SCI) is a chronic condition that results in high healthcare utilization and lifetime cost across the care continuum. In the absence of a standardized model of care delivery for SCI in western countries such as Canada, a scoping review of the literature was performed to identify and summarize existing international SCI models of care delivery. Four databases were searched using key words and subject headings for concepts such as: ''spinal cord injury,'' ''delivery of healthcare,'' ''model of care,'' ''patient care planning,'' and ''care pathway.'' Title, abstract, and full text review were competed by two independent reviewers. A combined total of 46 peer-reviewed and gray literature articles were included. No single SCI model of care has been adopted across different countries internationally. However, optimal attributes of models of care were identified, including the importance of having multidisciplinary SCI specialty care providers along the continuum, provision of rural SCI services and outreach, integration of primary care, peer mentoring, and using a hub and spokes model of care. These findings inform the future development of an SCI model of care, which ideally would serve all geographical locations and span the continuum of care, improving the health status and quality of life of persons with SCI.

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Primary care for persons with spinal cord injury — not a novel idea but still under-developed

Cited by 19 publications

References 6 publications

First Contact of Care for Persons With Spinal Cord Injury: A General Practitioner or a Spinal Cord Injury Specialist?

First Contact of Care for Persons With Spinal Cord Injury: A General Practitioner or a Spinal Cord Injury Specialist?

A Primary Care Provider’s Guide to Accessibility After Spinal Cord Injury

Models of Care Delivery from Rehabilitation to Community for Spinal Cord Injury: A Scoping Review

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