Rehospitalization following compensable work-related tetraplegia

Abstract

Design: Descriptive study. Objectives: To document the characteristics of rehospitalization following work-related tetraplegia, investigate risk factors for rehospitalization and identify opportunities for rehospitalization prevention. Setting: Workers' compensation administrative database with national coverage. Methods: The administrative database of a large workers' compensation provider was searched for work-related tetraplegia claims with dates of injury between 1 January 1989 and 31 December 1999. In all, 61 cases were identified where detailed rehospitalization information was available. Medical payment data were extracted, rehospitalization reasons were coded, and rates, costs and length of stay were calculated. Results: In all, 62% of cases were rehospitalized at some time during the period for which data were available. The average number of days the study group spent rehospitalized per year was 9.2 and the average annual cost was $14 197. The most common reasons for rehospitalization were dermatological (23%), orthopedic (18%) and urological (14%). It was found that as many as 74% of the total number of days persons spent rehospitalized, 64% of the monies spent on rehospitalization, and 47% of rehospitalizations could have been prevented. Conclusions: Consistent with earlier research, the ability to identify risk factors for rehospitalization was limited. However, the current study does highlight the extent to which rehospitalizations disrupt the lives of people with work-related tetraplegia and that a substantial proportion of rehospitalizations can be avoided.

Factors related to hospital readmissions in people with spinal cord injury in South Africa

“…People with spinal cord injury (PWSCI) spend extended periods of time in rehabilitation, where they learn to adjust to a new physical reality. [1] After discharge from rehabilitation, some PWSCI are readmitted for various reasons. Readmission can be disruptive and undermine rehabilitation achievements, ultimately diminishing an individual's ability to live an active and independent life.…”

Health care utilization in persons with spinal cord injury: part 2—determinants, geographic variation and comparison with the general population

“…12,13 In some cases, rehospitalizations are preventable through health maintenance strategies, such as promotion of selfcare or timely interference by experienced health professionals. 5,7,[14][15][16][17] Health care utilization rates often depend on place of residence through mechanisms of accessibility of care, 18 availability of specialized care, 19 provider-driven demand 20 or locally different patient preference. 21 Utilization of outpatient clinics and in-patient hospital services in persons with SCI were noted to decrease with longer travel distance to health care facilities.…”

The Economic Burden of Urinary Tract Infection and Pressure Ulceration in Acute Traumatic Spinal Cord Injury Admissions: Evidence for Comparative Economics and Decision Analytics from a Matched Case-Control Study

“…[55][56][57] In comparison, costs attributed to presumably more severe UTI in alternative patient populations are generally higher. 2,16,48,[58][59][60][61][62][63][64] The incremental cost of ''clinically significant'' hospital-acquired UTI in complex medical and surgical admissions in Ontario, Canada, for example, is reported to be $23,667. 48 Similarly, in two Australia SCI populations, hospitalacquired UTI reportedly added $24,569 and community-acquired UTI severe enough to result in hospitalization added $16,354 to the average costs of care.…”

“…Average costs of PU in general inpatient populations range from $2832 to $54,062, [46][47][48]56,57,[59][60][61] and costs of PU in SCI populations range from $18,533 to $104,135. 2,16,58,62,64,34,[88][89][90][91][92][93] The range is expected to reflect demographic and geographic differences in the population being studied as well as associated differences in the severity of PU in the study population. The range may also reflect differences in the research or costing methodologies, observation period, products and services used to manage or treat PU, and duration of PU treatment.…”