Utilization and access to healthcare services among community-dwelling people living with spinal cord injury

Hamilton, Rita; Driver, Simon; Noorani, Shayan; Callender, Librada; Bennett, Monica; Monden, Kimberley R.

doi:10.1080/10790268.2016.1184828

Cited by 55 publications

(59 citation statements)

References 25 publications

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“…The literature reports GP visit rates between 77 and 86%. 14,[39][40][41] In-patient hospitalization rates following initial rehabilitation were reported to range between 19 and 57% 6 and were reported as low as 13% 1 in the succeeding years. The present study found a slightly higher GP visit rate (88%), whereas the in-patient hospitalization rate (36%) was within the range described in the literature.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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“…2,3 Moreover, persons with SCI often require a comprehensive array of general, specialized and home-based health care services. 4 In these services, providers from different specialties are engaged including medical doctors and therapists, 5 and complementary and alternative medical services are claimed, based on patient preference. 6 Besides unplanned visits, as a result of secondary acute complications of SCI, planned visits are commonly offered to persons with SCI as annual check-ups.…”

Section: Introductionmentioning

confidence: 99%

Health care utilization in persons with spinal cord injury: part 1—outpatient services

et al. 2017

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“…Telehealth, when conducted by an experienced physiatrist, can efficiently link underserved areas with SCI specialists while minimizing extraneous expenses. 19 Unfortunately, motivating this population to participate in telehealth can prove challenging. Multiple studies have shown that lower participation rates in programs to improve health in the SCI population are correlated with lower incomes.…”

Section: Discussionmentioning

confidence: 99%

“…36 Additionally, a cohort study found that visits to a physiatrist were significantly lower in patients living in a rural area (p = 0.008). 19 One study reported a 14% decrease in participation rates for every twofold increase in travel distance. 5 Finally, the perception of physical barriers (e.g., accessibility) and actual lack of services were significantly higher in the rural group (p = 0.002 and p = 0.042, respectively).…”

Section: Ruralitymentioning

confidence: 99%

Outcomes in socioeconomically disadvantaged patients with spinal cord injury: a systematic review

Jorge¹,

White²,

Agarwal³

2018

Journal of Neurosurgery: Spine

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OBJECTIVEIndividuals with a spinal cord injury (SCI) in socioeconomically disadvantaged settings (e.g., rural or low income) have different outcomes than their counterparts; however, a contemporary literature review identifying and measuring these outcomes has not been published. Here, the authors’ aim was to perform a systematic review and identify these parameters in the hope of providing tangible targets for future clinical research efforts.METHODSA systematic review was performed to find English-language articles published from 2007 to 2017 in the PubMed/MEDLINE, EMBASE, and SCOPUS databases. Studies evaluating any outcomes related to patients with an SCI and in a low-resource setting were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and a flowchart was created. Of the 403 articles found, 31 underwent complete review and 26 were eligible for study inclusion. According to the current study criteria, any case studies, studies in less developed countries, studies including and not separating other types of neurological disorders, studies not assessing the effects of a low-resource setting on outcomes in patients with SCI, and studies evaluating the causes of SCI in a low-resource setting were excluded.RESULTSIn SCI patients, a lower income was a predictor of death (OR 2.1, 95% CI 1.7–2.6, p = 0.0002). Moreover, secondary outcomes such as pain intensities (OR 3.32, 95% CI 2.21–4.49, p < 0.001), emergency room visits (11% more likely, p = 0.006), and pressure ulcer formation (OR 2.1, 95% CI 1.5–3.0, p < 0.001) were significantly higher in the lower income brackets. Rurality was also a factor and was significantly associated with increased emergency room visits (OR 1.5, 95% CI 1.1–2.1, p = 0.01) and lower outpatient service utilization (incidence rate ratio [IRR] 0.57, 95% CI 0.35–0.93, p < 0.05).CONCLUSIONSThe authors showed that individuals in a low-resource setting who have suffered an SCI have significantly different outcomes than their counterparts. These specific outcomes are promising targets for future research efforts that focus on improving health conditions among this population.

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Utilization and access to healthcare services among community-dwelling people living with spinal cord injury

Cited by 55 publications

References 25 publications

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

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

Health care utilization in persons with spinal cord injury: part 1—outpatient services

Outcomes in socioeconomically disadvantaged patients with spinal cord injury: a systematic review

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