scholarly journals First contact of care for persons with spinal cord injury: a general practitioner or a spinal cord injury specialist?

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Dima Touhami ◽  
Mirjam Brach ◽  
Stefan Essig ◽  
Elias Ronca ◽  
Isabelle Debecker ◽  
...  
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Health Care Services ◽  
Secondary Conditions ◽  
Care Services ◽  
Cord Injury ◽  
Specific Care ◽  
First Contact ◽  
Use Of Health Care

Abstract Background Although general practitioners (GPs) are generally considered as the first point of contact for care, this may be different for persons with complex conditions, such as those with spinal cord injury (SCI). The objective of this study is to understand the differences in long-term care provision by GPs and SCI-specialists, by examining (1) the first contact of care for SCI health problems, (2) the morbidity profile and use of health-care services in relation to first contact, and (3) the factors associated with the choice of first contact. Methods In this cross-sectional study based on data derived from the Swiss Spinal Cord Injury Cohort Study Community Survey 2017, the main outcome measure was the reported first contact for SCI-specific care. This information was analysed using the chi-square test and logistic regression analysis of groups based on patient characteristics, use of health-care services and secondary health conditions assessed using the Spinal Cord Injury Secondary Conditions Scale (SCI-SCS). Results Out of 1294 respondents, 1095 reported their first contact for SCI-specific care; 56% indicated SCI-specialists and 44% specified GPs. On average, participants who first contacted a GP reported higher number of GP consultations (5.1 ± 5.2 vs. 3.9 ± 7.2), planned visits to ambulatory clinics (3.7 ± 7.3 vs. 3.6 ± 6.7) and hospital admissions (GP, 1.9 ± 1.7 vs. 1.5 ± 1.3), but lower number of visits to SCI-specialists (1.7 ± 1.8 vs. 2.6 ± 1.7) and of hospital days (22.8 ± 43.2 vs. 31.0 ± 42.8). The likelihood to contact a GP first was significantly higher in persons ≥75 years old (OR = 4.44, 95% CI = 1.85–10.69), Italian speakers (OR = 5.06, 95% CI = 2.44–10.47), had incomplete lesions (OR = 2.39, 95% CI = 1.71–3.35), experiencing pain (OR = 1.47, 95% CI = 1.04–2.09) or diabetes mellitus (OR = 1.85, 95% CI = 1.05–3.27), but lower for those situated closer to SCI centres (OR = 0.69, 95% CI = 0.51–0.93) or had higher SCI-SCS scores (OR = 0.92, 95% CI = 0.86–0.99). Conclusion Age, language region, travel distance to SCI centres, lesion completeness, and occurrence of secondary conditions play a significant role in determining the choice of first contact of care, however there is still some unwarranted variation that remains unclear and requires further research.

scholarly journals First Contact of Care for Persons With Spinal Cord Injury: A General Practitioner or a Spinal Cord Injury Specialist?

2021 ◽  
Author(s):  
Dima Touhami ◽  
Mirjam Brach ◽  
Stefan Essig ◽  
Elias Ronca ◽  
Isabelle Debecker ◽  
...  
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Health Care Services ◽  
Health Conditions ◽  
Care Services ◽  
Cord Injury ◽  
Specific Care ◽  
First Contact ◽  
Use Of Health Care

Abstract Background. Inter-professional collaboration between general practitioners (GPs) and spinal cord injury (SCI) specialists is needed to improve the health outcomes of persons with SCI. The objective of this study is to understand the differences in long-term care provision by GPs and SCI-specialists, by examining (1) the first contact of care for SCI health problems, (2) the morbidity profile and use of health-care services in relation to first contact, and (3) the factors associated with the choice of first contact.Methods. In this cross-sectional study based on data derived from the Swiss Spinal Cord Injury Cohort Study Community Survey 2017, the main outcome measure was the reported first contact for SCI-specific care. This information was analysed using the chi-square test and logistic regression analysis of groups based on patient characteristics, use of health-care services and secondary health conditions assessed using the Spinal Cord Injury Secondary Conditions Scale (SCI-SCS). Results. Out of 1294 respondents, 1095 reported their first contact for SCI-specific care; 56% indicated SCI-specialists and 44% specified GPs. The mean ± standard deviation of the total SCI-SCS was significantly lower in persons who initially consulted GPs (13.1±7.7) than SCI-specialists (14.6±7.3). On average, participants who first contacted a GP reported higher number of GP consultations (5.1±5.2 vs. 3.9±7.2), planned visits to ambulatory clinics (3.7±7.3 vs. 3.6±6.7) and hospital admissions (GP, 1.9±1.7 vs. 1.5±1.3), but lower number of hospital days (22.8±43.2 vs. 31.0±42.8). The likelihood to contact a GP first was significantly higher in persons ≥75 years old (OR= 4.78, 95%-CI= 1.99–11.50), Italian speakers (OR= 5.11, 95%-CI= 2.47–10.54), had incomplete lesions (OR 2.51, 95%-CI 1.78–3.54) or diabetes mellitus (OR= 1.81, 95%-CI= 1.03–3.18), but lower for those situated closer to SCI centers (OR= 0.69, 95%-CI= 0.51–0.93) or experiencing bowel dysfunction (OR= 0.71, 95%-CI= 0.52–0.98).Conclusion. The choice of first contact for SCI-specific care may be partly explained by the complementary roles of GPs and SCI specialists, but the reasons for variation are still unclear. Developing a transparent shared-care model between GPs and SCI specialists, with defined roles and responsibilities, may improve the management of secondary health conditions.

scholarly journals An Assessment of Cost of Access to Health Services of Severely Disabled People in Chitwan

2018 ◽  
pp. 102-112
Author(s):  
Chudamani Poudel ◽  
Ramesh Baral
Keyword(s):  
Health Care ◽  
Health Outcome ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Health Services ◽  
Health Care Services ◽  
Poor Health ◽  
Health Maintenance ◽  
Care Services ◽  
Cord Injury

There are many barriers that keep people with disabilities from fully engaging in health care services. This study assessed the direct medical, direct non-medical and indirect cost as well as potential barriers and obstacles that people with spinal cord injury and intellectual disabilities faced in accessing health care services. This study conducted in Chitwan district of Nepal used both quantitative and qualitative information. For quantitative study, structured interview were conducted to assess the cost involved in health care services with 60 persons divided into Physical (spinal cord injury) and intellectual disability. In-depth interviews and Focus Group Discussions (FGDs) were conducted for qualitative study to find out their experiences regarding barriers, coping strategies and their needs and expectation when accessing health care services.Physical (spinal cord injury) disability accounted 46.67% while 53.33% were intellectual disabled. 48.3% were in poor health and 51.67% in fair health condition. The total mean values of direct medical cost for both types of disability were Rs. 6682.53 in the past six month. The qualitative reports suggest that people with severe disability faces numbers of barriers in accessing health services. This is seen as the key reason for their poor health outcome. High cost incurred in medical services and physical health maintenance, worse socio-economic status, and layers of barriers in accessing health care services were the reason of poorer health outcome and exclusion from the society.Economic Journal of Development Issues Vol. 23&24 No. 1-2, (2017) Combined Issue, Page : 102-112

General practice visits by people with traumatic spinal cord injury: a Queensland longitudinal study

2014 ◽  
Vol 20 (2) ◽  
pp. 167 ◽  
Author(s):  
Delena Amsters ◽  
Sarita Schuurs ◽  
Melissa Kendall ◽  
Kiley Pershouse ◽  
Ruth Barker ◽  
...  
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Primary Health Care ◽  
Health Care Services ◽  
Traumatic Spinal Cord Injury ◽  
Service Utilisation ◽  
Care Services ◽  
Primary Health ◽  
Cord Injury

People with traumatic spinal cord injury (SCI), although proportionally fewer in number, are known to be high users of primary health care services; however, details of their visits to GPs are unclear. This study presents information about GP utilisation patterns of 193 people with SCI over a 5-year period. Results demonstrate substantially greater GP service utilisation, particularly for young men with SCI, compared with their counterparts in the general population. Interestingly, people with paraplegia were proportionally higher users of GP services than those with tetraplegia. Results indicate the need for specialist support for GPs to meet the SCI-specific needs of this patient group. Specialist SCI outreach teams may be a useful resource to primary health care practitioners.

Utilization of health care services by persons with spinal cord injury living in the community

1993 ◽  
Vol 74 (6) ◽  
pp. 672-673
Author(s):  
Era Buck ◽  
Diana H. Rintala ◽  
Karen A. Hart ◽  
Rebecca R. Clearman ◽  
Marcus J. Fuhrer
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Health Care Services ◽  
Care Services ◽  
Cord Injury

scholarly journals ICT-Based Health Care Services for Individuals with Spinal Cord Injuries: A Feasibility Study

Sensors ◽  
2020 ◽  
Vol 20 (9) ◽  
pp. 2491
Author(s):  
Wan-ho Jang ◽  
Seung-bok Lee ◽  
Dong-wan Kim ◽  
Yun-hwan Lee ◽  
Yun-jeong Uhm ◽  
...  
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Medical Care ◽  
Health Care Services ◽  
Spinal Cord Injuries ◽  
Smart Device ◽  
Management Service ◽  
Care Services ◽  
Cord Injury ◽  
Tract Infections

In the Republic of Korea, 90.5% of those living with spinal cord injury (SCI) are faced with medical complications that require chronic care. Some of the more common ones include urinary tract infections, pressure sores, and pain symptomatology. These and other morbidities have been recognized to deteriorate the individual’s health, eventually restricting their community participation. Telerehabilitation, using information and communication technology, has propelled a modern-day movement in providing comprehensive medical services to patients who have difficulty in mobilizing themselves to medical care facilities. This study aims to verify the effectiveness of health care and management in the SCI population by providing ICT-based health care services. We visited eight individuals living with chronic SCI in the community, and provided ICT-based health management services. After using respiratory and urinary care devices with the provision of home visit occupational therapy, data acquisition was achieved and subsequently entered into a smart device. The entered information was readily accessible to the necessary clinicians and researchers. The clients were notified if there were any concerning results from the acquired data. Subsequently, they were advised to follow up with their providers for any immediate medical care requirements. Digital hand-bike ergometers and specialized seating system cushions are currently in development. The ICT-based health care management service for individuals with SCI resulted in a favorable expected level of outcome. Based on the results of this study, we have proposed and are now in preparation for a randomized clinical trial.

scholarly journals STRENGHTS AND LIMITS IN THE DAILY LIFE OF THE ADHERENCE TO REHABILITATION OF PEOPLE WITH SPINAL CORD INJURY AND THEIR FAMILIES

2020 ◽  
Vol 29 ◽  
Author(s):  
Adriana Dutra Tholl ◽  
Rosane Gonçalves Nitschke ◽  
Selma Maria da Fonseca Viegas ◽  
Tassiana Potrich ◽  
Cristina Marques-Vieira ◽  
...  
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Daily Life ◽  
Rehabilitation Care ◽  
Interpretive Study ◽  
Care Services ◽  
Cord Injury ◽  
The Family ◽  
Data Collation

ABSTRACT Objective: to understand the strengths and limits in the daily life of the adherence to rehabilitation of people with spinal cord injury and their families. Method: an interpretive study of a qualitative nature, based on Comprehensive and Everyday Life Sociology, involving 21 participants, 12 individuals with spinal cord injury and 9 family members, in a Specialized Rehabilitation Center in southern Brazil. The sources of evidence were individual and collective interviews, adopting the strategy of workshops for data validation. The Atlas.ti software was used for data collation and organization. Data analysis involved the following stages: preliminary analysis, ordering, key links, coding, and categorization. Results: the following categories and subcategories were found: Strengths in the adherence to rehabilitation - welcoming and walking side by side; rehabilitation: a return to life; coexistence that brings the family together, as well as practicing faith. Limits on the adherence to rehabilitation - (d)efficiency of the health professionals in health care. Conclusion: rehabilitation was evidenced as a possibility of returning to life, which enables coexistence among equals and stimulates self-care and adaptation. The family rescues the desire to live, and faith is a mechanism of hope and optimism. It is noteworthy that the welcoming deficit in Primary Health Care and the scarcity of rehabilitation care services in the hospital determine the onset of avoidable complications, in addition to the lack of guidance and/or referrals, characterizing a gap in the Referral and Counter-Referral System.

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