Quality of Life and the Health System: A 22-Country Comparison of the Situation of People With Spinal Cord Injury

Barzallo, Diana Pacheco; Gross-Hemmi, Mirja; Bickenbach, Jerome; Juocevičius, Alvydas; Popa, Daiana; Wahyuni, Luh Karunia; Strøm, Vegard; InSCI,

doi:10.1016/j.apmr.2020.04.030

Cited by 31 publications

(27 citation statements)

References 23 publications

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“…The survey included all residents in participating countries living with SCI who provided informed consent and were able to respond to the questionnaire. 8 , 27 , 28 …”

Section: Methodsmentioning

confidence: 99%

“…The survey included all residents in participating countries living with SCI who provided informed consent and were able to respond to the questionnaire. 8,27,28 To date, exact numbers on the incidence, prevalence, and survival rates of SCI are inexistent. Most of the existent studies rely on approximations that show a great variability from country to country.…”

Section: Datamentioning

confidence: 99%

“… 5 , 6 , 7 Therefore, the health system and its service provisions have a key role, as the quality of life of persons with impairments is heavily dependent on their response and efficacy. 8 , 9 , 10 This puts a disproportionate pressure on the health care system, where the role of the social system becomes more relevant.…”

Section: Introductionmentioning

confidence: 99%

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Unmet health care needs and inequality: A cross‐country comparison of the situation of people with spinal cord injury

Barzallo

Oña

Gemperli

2021

Health Services Research

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Objective: To estimate and compare unmet health care needs of persons with spinal cord injury (SCI) across countries, the causes of these shortfalls, and the role of income.Data Sources: We analyzed cross-sectional data of 20 countries from the International Spinal Cord Injury (InSCI) survey, a compendium of comparable data on the living situation of persons with SCI. Data included information on high-, middle-, and low-income countries. The survey comprises information on 12,095 participants.Study Design: We used logit regressions to estimate the probability of unmet health care needs of persons with SCI and its causes. We adjusted the results by the individuals' characteristics and countries' fixed effects. We disaggregated the results by income decile of individuals in each country.Data Collection/Extraction Methods: The inclusion criteria for the InSCI survey were adults aged 18 years and older with SCI living in the community, who were able to respond to the survey and who provided informed consent.Principal Findings: Unmet health care needs are significant for people with long-term conditions like SCI, where people in low-income groups tend to be more affected.Among the barriers to meeting health care needs, the foremost is health care cost (in 11 of the 20 countries), followed by transportation and service availability.Persons with SCI in Morocco reported the highest probability of unmet health care needs in the sample, 0.54 (CI: 047-0.59), followed well behind by South Africa, 0.27

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“…The survey included all residents in participating countries living with SCI who provided informed consent and were able to respond to the questionnaire. 8 , 27 , 28 …”

Section: Methodsmentioning

confidence: 99%

Section: Datamentioning

confidence: 99%

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Unmet health care needs and inequality: A cross‐country comparison of the situation of people with spinal cord injury

Barzallo

Oña

Gemperli

2021

Health Services Research

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“…Although we estimated the health income gap using proxy variables for mortality, the indicators show the expected behavior in the total estimates, and across countries. With this paper, we claim that both measures, years living with the injury and the comorbidity index, are a good proxy for mortality, as the health status of persons with SCI is highly dependent on the performance of the health system and the quality of its services ( Pacheco Barzallo et al, 2020 ; World Health Organization and International Spinal Cord Society, 2013 , p. 231). If the response of the social and health systems were appropriate, inequalities due to income should be ineligible, where people with SCI should have a similar health outcome across income groups.…”

Section: Discussionmentioning

confidence: 99%

Health inequalities and income for people with spinal cord injury. A comparison between and within countries

Oña

Strøm

Lee

et al. 2021

SSM - Population Health

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Income and health are related in a bi-directional manner, whereby level of income affects health and vice versa. People in poorer households tend to experience worse health status and higher mortality rates than people in wealthier households, and, at the same time, having poor health could restrict workability leading to less income. This gap exists in almost every country, and it is more pronounced in more unequal countries and in vulnerable populations, such as people experiencing disability. The goal of this paper is to estimate the health-income gap in people with a Spinal Cord Injury (SCI), which is a chronic health condition often associated with multiple comorbidities that leads to disability. As data on mortality is inexistent, to estimate the health-income gap for persons with SCI, this paper uses two health outcomes: the number of years a person has lived with the injury, and a comorbidity index. Data was obtained from the International Spinal Cord Injury survey (InSCI), which is the first worldwide survey on community-dwelling persons with SCI. To compare across countries, the health outcomes were adjusted through hierarchical models, accounting for country fixed-effects, individual characteristics such as age and gender, and injury characteristics (cause, type and degree). Our results suggest that for the years living with SCI, the gap varies from 1 to 6 years between the lowest and the highest income groups. The main driver of such a difference is the cause of injury, where injuries caused by work accidents showed the biggest gap. Similarly, for the comorbidity index, persons with SCI in poorer deciles reported significantly more comorbidities, forty times more, than people in richer deciles.

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“…As a result, the management of medical emergencies is a priority in health system policy. It requires the cooperation of all the actors involved both upstream (pre-hospital emergency medicine) and downstream (hospital emergency medicine) of emergency services [1,2].…”

Section: Introductionmentioning

confidence: 99%

Self-Assessment of Biomedical Activity Related to Medical Devices Embedded in EMS Ambulances: Towards a Roadmap for an Efficient Improvement

Moussaid¹,

Bouaouine²,

Ngote³

2021

TOBEJ

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Objective: The present investigation is focused on a self-assessment of the biomedical activity related to embedded Medical Devices on board a fleet of 46 EMS medicalized ambulances, according to the High Authority of Health standard (criterion 8K) and the Guide of the Good Practices of Biomedical Engineering. Materials and Methods: The methodology adopted for this purpose is based on an analysis allowing the evaluation and observation of practices related to biomedical activity in these ambulances. An initial assessment, carried out in March 2021, made it possible to measure the gaps between the actual situation and the recommendations of the two self-diagnosis tools (High Authority of Health and Guide of the Good Practices of Biomedical Engineering standards). A series of corrective actions were proposed and then implemented. A second self-assessment took place after 6 months, in October 2021. Results: Between March and October 2021, an improvement in the scores for almost all the axes of the two self-assessment tools was noted. Indeed, the score of the self-assessment for the High Authority of Health reference system rose from 44% in March 2021 to 63% in October 2021, i.e. an increase of 19%, and that of the Guide of the Good Practices of Biomedical Engineering increased from 67.54% in March 2021 to 80.96% in October 2021, i.e. an increase of 13.42%. Conclusion: The implementation of a maintenance strategy integrating the notion of quality, relevant procedures and pertinent work tools has made it possible to significantly improve the biomedical activity within the medical ambulances and to optimise the embedded medical devices.

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Quality of Life and the Health System: A 22-Country Comparison of the Situation of People With Spinal Cord Injury

Cited by 31 publications

References 23 publications

Unmet health care needs and inequality: A cross‐country comparison of the situation of people with spinal cord injury

Unmet health care needs and inequality: A cross‐country comparison of the situation of people with spinal cord injury

Health inequalities and income for people with spinal cord injury. A comparison between and within countries

Self-Assessment of Biomedical Activity Related to Medical Devices Embedded in EMS Ambulances: Towards a Roadmap for an Efficient Improvement

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