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

Barzallo, Diana Pacheco; Oña, Ana; Gemperli, Armin

doi:10.1111/1475-6773.13738

Cited by 19 publications

(12 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This clearly shows that health care systems around the world often fail to adequately address the rehabilitation needs voiced by persons with SCI. This is in line with a report on health care needs in twenty InSCI countries in which health care cost, transportation, and service availability were identified as the most important unmet needs, and persons with SCI in lower-income groups were disproportionately impacted by this situation [14].…”

Section: Discussionsupporting

confidence: 88%

“…Persons with SCI represent a high needs, high-cost group with significant unmet health care needs. These needs are mostly due to the costs of health services, transportation, and lack of available services [ 14 ]. This is common in low-, middle-, and high-income countries, where persons in lower-income groups are disproportionately affected.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Relationship between secondary health conditions and life satisfaction in persons with spinal cord injury: study across twenty-one countries

et al. 2023

View full text Add to dashboard Cite

Purpose To determine the relationships between impact of secondary health conditions (SHCs), treatment of SHCs, and life satisfaction (LS) following spinal cord injury (SCI) across 21 countries. Hypotheses were as follows: (1) Persons with SCI and fewer SHCs report higher LS and (2) Persons who receive treatment for SHCs report higher LS than those who do not receive treatment. Methods Cross-sectional survey, including 10,499 persons with traumatic or non-traumatic SCI aged 18 years or older and living in the community. To assess SHCs, 14 items adapted from the SCI-Secondary Conditions Scale were used (range 1–5). SHCs index was calculated as the mean of all 14 items. LS was assessed using a selection of 5 items from the World Health Organization Quality of Life Assessment. LS index was calculated as the mean of these 5 items. Results South Korea, Germany, and Poland exhibited the highest (2.40–2.93) and Brazil, China, and Thailand the lowest (1.79–1.90) impact of SHCs. Indexes for LS and SHCs were inversely correlated (– 0.418; p < 0.001). Mixed Model Analysis showed that the fixed effect (key predictors of the study) of SHCs index (p < 0.001) and the positive interaction between SHCs index and treatment (p = 0.002) were significant determinants of LS. Conclusion Persons with SCI across the world are more likely to perceive better LS if they experience fewer SHCs and receive treatment for SHCs, in comparison to those who do not. Prevention and treatment of SHCs following SCI should be a high priority in order to improve the lived experience and enhance LS.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Relationship between secondary health conditions and life satisfaction in persons with spinal cord injury: study across twenty-one countries

et al. 2023

View full text Add to dashboard Cite

show abstract

“…To adapt private homes, financial support or inexpensive credit can be provided. Similarly, availability of adequate transportation is of extreme relevance as it is one of the main barriers to meet health care needs [ 63 ]. In many countries, regulations that require public transportation to be able to accommodate persons in a wheelchair already exist, but require a stricter enforcement.…”

Section: Discussionmentioning

confidence: 99%

Ageing, functioning patterns and their environmental determinants in the spinal cord injury (SCI) population: A comparative analysis across eleven European countries implementing the International Spinal Cord Injury Community Survey

et al. 2023

Self Cite

View full text Add to dashboard Cite

Background As the European population with Spinal Cord Injury (SCI) is expected to become older, a better understanding of ageing with SCI using functioning, the health indicator used to model healthy ageing trajectories, is needed. We aimed to describe patterns of functioning in SCI by chronological age, age at injury and time since injury across eleven European countries using a common functioning metric, and to identify country-specific environmental determinants of functioning. Methods Data from 6’635 participants of the International Spinal Cord Injury Community Survey was used. The hierarchical version of Generalized Partial Credit Model, casted in a Bayesian framework, was used to create a common functioning metric and overall scores. For each country, linear regression was used to investigate associations between functioning, chronological age, age at SCI or time since injury for persons with para- and tetraplegia. Multiple linear regression and the proportional marginal variance decomposition technique were used to identify environmental determinants. Results In countries with representative samples older chronological age was consistently associated with a decline in functioning for paraplegia but not for tetraplegia. Age at injury and functioning level were associated, but patterns differed across countries. An association between time since injury and functioning was not observed in most countries, neither for paraplegia nor for tetraplegia. Problems with the accessibility of homes of friends and relatives, access to public places and long-distance transportation were consistently key determinants of functioning. Conclusions Functioning is a key health indicator and the fundament of ageing research. Enhancing methods traditionally used to develop metrics with Bayesian approach, we were able to create a common metric of functioning with cardinal properties and to estimate overall scores comparable across countries. Focusing on functioning, our study complements epidemiological evidence on SCI-specific mortality and morbidity in Europe and identify initial targets for evidence-informed policy-making.

show abstract

“…Individuals with SCI experience access barriers to health care due to physical distance to facilities, transportation challenges, lack of availability of specialized care, and health care cost (Barrows & Goldstein, 2021; LaVela et al, 2004; Pacheco Barzallo et al, 2021). It is possible that the themes identified by veterans with SCI in this study, pointing to unmet care needs, may be even more challenging for nonveterans with SCI, given the access advantages that many veterans with SCI have, including health care cost benefits and VA-supplied health care transportation services.…”

Section: Discussionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on individuals living with spinal cord injury: A qualitative study.

LaVela¹,

Wu²,

Nevedal³

et al. 2023

Rehabilitation Psychology

View full text Add to dashboard Cite

Purpose/Objective: To explore the impact of the COVID-19 pandemic as experienced and reported by individuals living with a spinal cord injury (SCI). Research Method/Design: Descriptive qualitative design using in-depth semistructured interviews with individuals with SCI (n = 33) followed by thematic analysis. Results: Three main themes described impacts of the COVID-19 pandemic. (a) Impact on health care use; subthemes elaborated that this was attributable to in-person health care facility restrictions or individual decisions to delay care. Individuals with SCI experienced lapses in primary and SCI-specialty care, rehabilitation/therapy services, and home care, but some made use of telehealth services. (b) Impact on weight and/or weight management lifestyle behaviors; subthemes discussed that engagement in physical activity declined because of fitness center closures, recreational activity cancellations, and safety precautions limiting community-based and outdoor activities. The pandemic disrupted participants’ independence in purchasing and making preferred food selections which impacted healthy eating. Participants ate due to boredom, at nonmealtimes, and consumed unhealthy foods during the pandemic. (c) Impact on psychosocial factors; included subthemes noting reduced social interactions, social participation, and ability to pursue pastimes with family, friends, and groups they belonged to. The pandemic also triggered emotional reactions such as worry, fear, doubt, demotivation, and feelings of social isolation. Conclusions: Our findings highlight the magnitude of consequences faced by individuals with SCI when restrictions to health care, healthy lifestyle endeavors, and social participation occurred during the COVID-19 pandemic. Findings may inform SCI health care providers on what is needed in response to future public health or natural disaster crises.

show abstract

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

Cited by 19 publications

References 38 publications

Relationship between secondary health conditions and life satisfaction in persons with spinal cord injury: study across twenty-one countries

Relationship between secondary health conditions and life satisfaction in persons with spinal cord injury: study across twenty-one countries

Ageing, functioning patterns and their environmental determinants in the spinal cord injury (SCI) population: A comparative analysis across eleven European countries implementing the International Spinal Cord Injury Community Survey

The impact of the COVID-19 pandemic on individuals living with spinal cord injury: A qualitative study.

Contact Info

Product

Resources

About