Factors influencing specialized health care utilization by individuals with spinal cord injury: a cross-sectional survey

Author(s):  
Elias Ronca ◽  
Anke Scheel-Sailer ◽  
Inge Eriks-Hoogland ◽  
Mirjam Brach ◽  
Isabelle Debecker ◽  
...  
Spinal Cord ◽  
2009 ◽  
Vol 48 (1) ◽  
pp. 45-50 ◽  
Author(s):  
S J T Guilcher ◽  
S E P Munce ◽  
C M Couris ◽  
K Fung ◽  
B C Craven ◽  
...  

2018 ◽  
Author(s):  
W Ben Mortenson ◽  
Patricia Branco Mills ◽  
Jared Adams ◽  
Gurkaran Singh ◽  
Megan MacGillivray ◽  
...  

BACKGROUND Most people with spinal cord injury will develop secondary complications with potentially devastating consequences. Self-management is a key prevention strategy for averting the development of secondary complications and their recurrence. Several studies have shown that self-management programs improve self-management behaviors and health outcomes in individuals living with chronic conditions such as asthma, diabetes, hypertension, and arthritis. Given the burgeoning health care costs related to secondary complications, we developed an alternative electronic health–based implementation to facilitate the development of self-management skills among people with spinal cord injury. OBJECTIVE This study aims to evaluate the efficacy of a self-management app in spinal cord injury populations. The primary outcome is attainment of self-selected, self-management goals. Secondary outcomes include increases in general and self-management self-efficacy and reductions in self-reported health events, health care utilization, and secondary complications related to spinal cord injury. This study also aims to explore how the intervention was implemented and how the app was experienced by end users. METHODS This study will employ a mix of qualitative and quantitative methods. The quantitative portion of our study will involve a rater-blinded, randomized controlled trial with a stepped wedge design (ie, delayed intervention control group). The primary outcome is successful goal attainment, and secondary outcomes include increases in self-efficacy and reductions in self-reported health events, health care utilization, and secondary conditions related to spinal cord injury. The qualitative portion will consist of semistructured interviews with a subsample of the participants. RESULTS We expect that the mobile self-management app will help people with spinal cord injury to attain their self-management goals, improve their self-efficacy, reduce secondary complications, and decrease health care utilization. CONCLUSIONS If the results are positive, this study will produce credible new knowledge describing multiple outcomes that people with spinal cord injury realize from an app-based self-management intervention and support its implementation in clinical practice. CLINICALTRIAL ClinicalTrials.gov NCT03140501; http://clinicaltrials.gov/ct2/show/NCT03140501 (Archived by WebCite at http://www.webcitation.org/73Gw0ZlWZ) INTERNATIONAL REGISTERED REPOR PRR1-10.2196/11069


2011 ◽  
Vol 34 (7) ◽  
pp. 531-541 ◽  
Author(s):  
Sara J.T. Guilcher ◽  
B. Cathy Craven ◽  
Mary Ann McColl ◽  
Louise Lemieux-Charles ◽  
Tiziana Casciaro ◽  
...  

Spinal Cord ◽  
2017 ◽  
Vol 55 (9) ◽  
pp. 823-827 ◽  
Author(s):  
A Gemperli ◽  
◽  
E Ronca ◽  
A Scheel-Sailer ◽  
H G Koch ◽  
...  

2014 ◽  
Vol 95 (6) ◽  
pp. 1114-1126 ◽  
Author(s):  
Michael D. Stillman ◽  
Karen L. Frost ◽  
Craig Smalley ◽  
Gina Bertocci ◽  
Steve Williams

1999 ◽  
Vol 15 (4) ◽  
pp. 749-766 ◽  
Author(s):  
V. L. Phillips ◽  
Ann Temkin ◽  
Susan Vesmarovich ◽  
Richard Burns ◽  
Lynda Idleman

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.


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