Examining health-care utilization in the first year following spinal cord injury

Short Title:
Examining health-care utilization in the first year following spinal cord injury
Model System:
SCI
Reference Type:
Journal Article
Accession No.:
J71277
Journal:
JOURNAL OF SPINAL CORD MEDICINE
Year, Volume, Issue, Page(s):
2015, vol. 1, issue 42652, pp PMID: 25299152
Publication Website:
Abstract:
Study identified factors associated with health-care utilization during the first year after inpatient rehabilitation (IR) in individuals with traumatic spinal cord injury (SCI). One hundred sixty-eight patients were followed over 1 year after discharge from an SCI Model System IR program. Telephone follow-up occurred at 3, 6, 9, and 12 months. Participants were grouped into four impairment levels: (1) C1–4 American Spinal Injury Association (ASIA) Impairment Scale (AIS) A–C, (2) C5–C8 AIS A–C, (3) paraplegia AIS A–C, and (4) all AIS D. Three domains of healthcare utilization were examined: hospital care, outpatient provider visits, and home services. Health-care utilization in the first year following IR was high with 45 percent of subjects reporting re-hospitalization. Twenty percent of patients were initially discharged to a skilled nursing facility (SNF), and an additional 10 percent required SNF care during this first year. Overall, those with C1–4 AIS A–C used the most services. Participants discharged home used less health care compared to those discharged elsewhere. SCI due to falls (versus vehicular crashes) was associated with fewer in-home service visits. Age, sex, race, and education were unrelated to higher use. Those with greater neurological impairment or not discharged home after IR had higher health-care utilization, while age was not associated with utilization. Targeted efforts to reduce genitourinary and respiratory complications may reduce the need for hospital care in the first year after IR.
Author(s):
Kisala, P.A., Victorson, D., Choi, S., Heinemann, A.W., Pace, N., & Tulsky, D.S.
Author Address(es):
Participating Centers:

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