Utilization and access to healthcare services among community-dwelling people living with spinal cord injury. (4th May 2017)

• Record Type: Journal Article
• Authors: Hamilton, Rita; Driver, Simon; Noorani, Shayan; Callender, Librada; Bennett, Monica; Monden, Kimberley
• Is Part Of: Journal of spinal cord medicine. Volume 40:Number 3(2017:May)
• Page Start: 321
• Page End: 328
• Publication Date: 2017-05-04
• Subjects: Accessibility -- Satisfaction -- Healthcare services -- Disability -- Rehabilitation -- Injury -- Outpatient -- Spinal cord injury; Spinal cord -- Wounds and injuries -- Periodicals; Spinal cord -- Diseases -- Periodicals; 616.8305
• DOI: 10.1080/10790268.2016.1184828
• Languages: English
• ISSNs: 1079-0268

Abstract

Abstract : Objective : Describe the utilization, accessibility, and satisfaction of primary and preventative health-care services of community-dwelling individuals with spinal cord injury (SCI). Design : Cross sectional, in-person or telephonic survey, utilizing a convenience sample. Setting : Community. Participants : Individuals with SCI greater than 12-months post injury. Interventions : N/A. Outcome measures : Demographic, injury related, and 34-item questionnaire of healthcare utilization, accessibility, and satisfaction with services. Results : The final sample consisted of 142 participants (50 female, 92 male). Ninety-nine percent of respondents had a healthcare visit in the past 12-months with primary care physicians (79%), with SCI physiatrists (77%) and urologists (50%) being the most utilized. 43% of the sample reported an ER visit within the past 12-months, with 21% reporting multiple visits. People who visited the ER had completed significantly less secondary education (P = 0.0386) and had a lower estimate of socioeconomic status (P = 0.017). The majority of individuals (66%) were satisfied with their primary care physician and 100% were satisfied with their SCI physiatrist. Individuals who did not visit an SCI physiatrist were significantly more likely to live in a rural area (P = 0.0075), not have private insurance (P = 0.0001), and experience a greater decrease in income post injury (P = 0.010). Conclusion : The delivery of care for people with SCI with low socioeconomic status may be remodeled to include patient-centered medical homes where care is directed by an SCI physiatrist. Further increased telehealth efforts would allow for SCI physiatrists to monitor health conditions remotely and focus on preventative treatment.