scholarly journals Association of Race, Socioeconomic Status, and Health Care Access With Pressure Ulcers After Spinal Cord Injury

2012 ◽  
Vol 93 (6) ◽  
pp. 972-977 ◽  
Author(s):  
Lee L. Saunders ◽  
James S. Krause ◽  
Joshua Acuna
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Socioeconomic Status ◽  
Health Care Access ◽  
Pressure Ulcers ◽  
Care Access ◽  
Cord Injury ◽  
Socioeconomic Status And Health

Health Care Access and Utilization After Spinal Cord Injury

2014 ◽  
Vol 95 (10) ◽  
pp. e82
Author(s):  
Lee Saunders ◽  
David Murday ◽  
James S. Krause
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Health Care Access ◽  
Care Access ◽  
Cord Injury

Determinants of Health Care Access After Spinal Cord Injury

2013 ◽  
Vol 44 (2) ◽  
pp. 11-17
Author(s):  
Veronica Umeasiegbu
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Health Care Access ◽  
Access To Health Care ◽  
Rehabilitation Counseling ◽  
Care Access ◽  
Access To Health ◽  
Cord Injury ◽  
Race Ethnicity

This paper presents a review of the literature examining determinants of access to health care among individuals with spinal cord injury (SCI). The literature shows that health insurance, race-ethnicity, income, age, gender, and residential location (rural/urban) are common themes discussed in the literature as factors that influence access to health care of persons with SCI. This review ends with discussion of implications for rehabilitation counseling research and practice.

USING TELEHEALTH INTERVENTIONS TO PREVENT PRESSURE ULCERS IN NEWLY INJURED SPINAL CORD INJURY PATIENTS POST-DISCHARGE

1999 ◽  
Vol 15 (4) ◽  
pp. 749-766 ◽  
Author(s):  
V. L. Phillips ◽  
Ann Temkin ◽  
Susan Vesmarovich ◽  
Richard Burns ◽  
Lynda Idleman
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Health Care Utilization ◽  
Pressure Ulcers ◽  
Injury Rate ◽  
Self Report ◽  
Care Utilization ◽  
Cord Injury ◽  
Employment Rates

Objective: To determine which of three approaches to care produces the lowest incidence of pressure ulcers, promotes the most effective care of sores that develop, and leads to the fewest hospitalizations in newly injured patients with spinal cord injury after discharge.Methods: Spinal cord injury patients (n = 12) were recruited for a telehealth intervention after initial injury, and matched cases were recruited for telephone counseling and standard care groups. Patients were monitored for 6–8 months after discharge.Results: The video group had the greatest number of reported and identified pressure ulcers. Differences in health care utilization between the video and telephone telehealth groups were small. The standard care group reported the lowest number of pressure ulcers and lowest frequency of health care utilization. Substantial differences existed in employment rates before and after injury. The video group had the lowest pre-injury rate of employment and the highest post-injury rate of employment.Conclusions: Tracking pressure ulcer incidence, particularly stage I sores, is difficult. Self-report is likely to lead to substantial underreporting. Similarly, self-report on health care utilization over extended periods may lead to undercounting of encounters. Telehealth interventions appear to improve ulcer tracking and management of all ulcer occurrences. Video interventions may affect outcomes, such as employment rates, which are not conventionally measured.

scholarly journals Development of Predictive Informatics Tool Using Electronic Health Records to Inform Personalized Evidence-Based Pressure Injury Management for Veterans with Spinal Cord Injury

2021 ◽  
Vol 186 (Supplement_1) ◽  
pp. 651-658
Author(s):  
Kath M Bogie ◽  
Steven K Roggenkamp ◽  
Ningzhou Zeng ◽  
Jacinta M Seton ◽  
Katelyn R Schwartz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
User Interface ◽  
Veterans Health Administration ◽  
Study Cohort ◽  
Veterans Health ◽  
Health Administration ◽  
Cord Injury

ABSTRACT Background Pressure injuries (PrI) are serious complications for many with spinal cord injury (SCI), significantly burdening health care systems, in particular the Veterans Health Administration. Clinical practice guidelines (CPG) provide recommendations. However, many risk factors span multiple domains. Effective prioritization of CPG recommendations has been identified as a need. Bioinformatics facilitates clinical decision support for complex challenges. The Veteran’s Administration Informatics and Computing Infrastructure provides access to electronic health record (EHR) data for all Veterans Health Administration health care encounters. The overall study objective was to expand our prototype structural model of environmental, social, and clinical factors and develop the foundation for resource which will provide weighted systemic insight into PrI risk in veterans with SCI. Methods The SCI PrI Resource (SCI-PIR) includes three integrated modules: (1) the SCIPUDSphere multidomain database of veterans’ EHR data extracted from October 2010 to September 2015 for ICD-9-CM coding consistency together with tissue health profiles, (2) the Spinal Cord Injury Pressure Ulcer and Deep Tissue Injury Ontology (SCIPUDO) developed from the cohort’s free text clinical note (Text Integration Utility) notes, and (3) the clinical user interface for direct SCI-PIR query. Results The SCI-PIR contains relevant EHR data for a study cohort of 36,626 veterans with SCI, representing 10% to 14% of the U.S. population with SCI. Extracted datasets include SCI diagnostics, demographics, comorbidities, rurality, medications, and laboratory tests. Many terminology variations for non-coded input data were found. SCIPUDO facilitates robust information extraction from over six million Text Integration Utility notes annually for the study cohort. Visual widgets in the clinical user interface can be directly populated with SCIPUDO terms, allowing patient-specific query construction. Conclusion The SCI-PIR contains valuable clinical data based on CPG-identified risk factors, providing a basis for personalized PrI risk management following SCI. Understanding the relative impact of risk factors supports PrI management for veterans with SCI. Personalized interactive programs can enhance best practices by decreasing both initial PrI formation and readmission rates due to PrI recurrence for veterans with SCI.

scholarly journals Trending Racial and Socioeconomic Inequality in the Surgical Management and Outcome of Traumatic Cervical Spinal Cord Injury With Fracture In the USA From 1998 to 2009

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Alexander Dru ◽  
Dan Neal ◽  
W Christopher Fox ◽  
Brian Lim Hoh ◽  
Daniel J Hoh
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Socioeconomic Status ◽  
Hospital Mortality ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Lower Odds ◽  
Discharge Disposition ◽  
Treatment Type ◽  
Cord Injury

Abstract INTRODUCTION Advances in treatment of traumatic cervical spinal cord injury with fracture (TCSCIF) have led to significant improvements in clinical outcomes; however, progress in healthcare is seldom ubiquitous across demographic groups. We explored if disparities in treatment and outcome after TCSCIF exist across race and socioeconomic status. METHODS We queried the Nationwide Inpatient Sample database from 1998 to 2009 for TCSCIF hospitalizations. Multivariate analysis was used to identify the correlation between socioeconomic status and race to treatment type and outcome. RESULTS There were 21 985 admissions for TCSCIF. In all 66.9% had a favorable discharge disposition. In-hospital mortality rate was 12.5%. In all 43.7% underwent surgery. Overall, surgery was associated with lower in-hospital mortality (OR 0.30, 95% CI 0.27-0.34, P < .01) and better discharge disposition (OR 0.68, 95% CI 0.62-0.74, P < .01) vs nonsurgical or no intervention. Controlling for race and socioeconomic status demonstrated higher status (HS) non-Caucasians had lower odds of receiving surgery than HS Caucasians (OR 0.89, 95% CI 0.81-0.97, P = .01). LSES non-Caucasians had lower odds of receiving surgery than HS Caucasians (OR 0.83, 95% CI 0.73-0.94, P < .01). HS non-Caucasians had lower odds of receiving surgery than LSES Caucasians (OR 0.87, 95% CI 0.77-0.99, P = .03). LSES non-Caucasians had lower odds of receiving surgery than LSES Caucasians (OR 0.82, 95% CI 0.71-0.94, P = .01). For favorable discharge status HS non-Caucasians, LSES non-Caucasians, and LSES Caucasians all had lower odds of favorable discharge compared to HS Caucasians (OR 0.83, 95% CI 0.73-0.95, P = .01/OR 0.69, 95% CI 0.59-0.81, P < .01/OR 0.75, 95% CI 0.66-0.85, P < .01), respectively. CONCLUSION In our multivariate model that controlled for race and socioeconomic status in the setting of TCSCIF, race (but not socioeconomic status) was a factor in receiving surgery and both race and LSES impacted favorable discharge.

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