scholarly journals Spinal Cord Injury Veterans’ Disability Benefits, Outcomes, and Health Care Utilization Patterns: Protocol for a Qualitative Study

10.2196/14039 ◽  
2019 ◽  
Vol 8 (10) ◽  
pp. e14039
Author(s):  
Denise C Fyffe ◽  
Joyce Williams ◽  
Paul Tobin ◽  
Carol Gibson-Gill
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
New Jersey ◽  
Data Collection ◽  
Qualitative Study ◽  
Care Providers ◽  
Financial Compensation ◽  
Cord Injury ◽  
Disability Compensation

Background An estimated 42,000 people currently living with chronic spinal cord injury (SCI) are veterans. SCI was a common combat-related injury in the World Wars and Vietnam era and now affects more than 11% of military personnel injured in Operation Iraqi Freedom and Operation Enduring Freedom. The Veterans Benefits Administration primarily offers financial compensation for disabilities sustained or re-aggravated during military service, called service-connected disability compensation. With the overwhelming cost of living with an SCI, this monthly financial compensation can provide service-connected veterans and their families with access to additional supportive resources (eg, assistive devices and personal aide) and maintain their quality of life (QOL). Little is known about personal, health, functional, and QOL outcomes associated with service-connected and nonservice-connected status for veterans living with an SCI. Objective The aim of this study is to compare the ways in which Veterans Affairs’ (VA) service-connected and nonservice-connected status may be associated with health and functional outcomes, choice of health care provider, and overall QOL for veterans living with an SCI and their caregivers. Methods This cross-sectional qualitative study will gather data using retrospective chart reviews, semistructured interviews, and focus groups. After obtaining institutional review board (IRB) approval, purposeful sampling techniques will be used to recruit and enroll the following key stakeholders: veterans living with an SCI, family caregivers, and SCI health care providers. Concurrent data collection will take place at 2 sites: Veterans Administration New Jersey Healthcare System and Northern New Jersey Spinal Cord Injury System. Results This study was funded in July 2015. IRB approval was obtained by November 2016 at both sites. Enrollment and data collection for phase 1 to phase 4 are complete. A total of 69 veterans, 18 caregivers, and 19 SCI clinicians enrolled in the study. Data analyses for these phases are underway. In phase 5, the follow-up focus group activities are scheduled. The final results are expected by the end of 2019. Conclusions The factors that contribute to veterans living with SCI seeking and not seeking VA disability compensation benefits are not well understood in rehabilitation research. Triangulation of these data sources will allow us to compare, contrast, and integrate the results, which can be used to develop clinical guidelines, caregiver training, and patient education programs. International Registered Report Identifier (IRRID) DERR1-10.2196/14039

scholarly journals Spinal Cord Injury Veterans’ Disability Benefits, Outcomes, and Health Care Utilization Patterns: Protocol for a Qualitative Study (Preprint)

2019 ◽  
Author(s):  
Denise C Fyffe ◽  
Joyce Williams ◽  
Paul Tobin ◽  
Carol Gibson-Gill
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
New Jersey ◽  
Data Collection ◽  
Qualitative Study ◽  
Care Providers ◽  
Financial Compensation ◽  
Cord Injury ◽  
Disability Compensation

BACKGROUND An estimated 42,000 people currently living with chronic spinal cord injury (SCI) are veterans. SCI was a common combat-related injury in the World Wars and Vietnam era and now affects more than 11% of military personnel injured in Operation Iraqi Freedom and Operation Enduring Freedom. The Veterans Benefits Administration primarily offers financial compensation for disabilities sustained or re-aggravated during military service, called service-connected disability compensation. With the overwhelming cost of living with an SCI, this monthly financial compensation can provide service-connected veterans and their families with access to additional supportive resources (eg, assistive devices and personal aide) and maintain their quality of life (QOL). Little is known about personal, health, functional, and QOL outcomes associated with service-connected and nonservice-connected status for veterans living with an SCI. OBJECTIVE The aim of this study is to compare the ways in which Veterans Affairs’ (VA) service-connected and nonservice-connected status may be associated with health and functional outcomes, choice of health care provider, and overall QOL for veterans living with an SCI and their caregivers. METHODS This cross-sectional qualitative study will gather data using retrospective chart reviews, semistructured interviews, and focus groups. After obtaining institutional review board (IRB) approval, purposeful sampling techniques will be used to recruit and enroll the following key stakeholders: veterans living with an SCI, family caregivers, and SCI health care providers. Concurrent data collection will take place at 2 sites: Veterans Administration New Jersey Healthcare System and Northern New Jersey Spinal Cord Injury System. RESULTS This study was funded in July 2015. IRB approval was obtained by November 2016 at both sites. Enrollment and data collection for phase 1 to phase 4 are complete. A total of 69 veterans, 18 caregivers, and 19 SCI clinicians enrolled in the study. Data analyses for these phases are underway. In phase 5, the follow-up focus group activities are scheduled. The final results are expected by the end of 2019. CONCLUSIONS The factors that contribute to veterans living with SCI seeking and not seeking VA disability compensation benefits are not well understood in rehabilitation research. Triangulation of these data sources will allow us to compare, contrast, and integrate the results, which can be used to develop clinical guidelines, caregiver training, and patient education programs. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/14039

scholarly journals A Primary Care Provider’s Guide to Preventive Health After Spinal Cord Injury

2020 ◽  
Vol 26 (3) ◽  
pp. 209-219
Author(s):  
James Milligan ◽  
Stephen Burns ◽  
Suzanne Groah ◽  
Jeremy Howcroft
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Preventive Care ◽  
Primary Care Providers ◽  
Preventive Health ◽  
Care Providers ◽  
Health Maintenance ◽  
Cord Injury

Objective: Provide guidance for preventive health and health maintenance after spinal cord injury (SCI) for primary care providers (PCPs). Main message: Individuals with SCI may not receive the same preventive health care as the general population. Additionally, SCI-related secondary conditions may put their health at risk. SCI is considered a complex condition associated with many barriers to receiving quality primary care. Attention to routine preventive care and the unique health considerations of persons with SCI can improve health and quality of life and may prevent unnecessary health care utilization. Conclusion: PCPs are experts in preventive care and continuity of care, however individuals with SCI may not receive the same preventive care due to numerous barriers. This article serves as a quick reference for PCPs.

Utilization of health care providers by individuals with chronic spinal cord injury

Spinal Cord ◽  
2021 ◽  
Vol 59 (4) ◽  
pp. 373-380 ◽  
Author(s):  
Armin Gemperli ◽  
Mirjam Brach ◽  
Isabelle Debecker ◽  
Inge Eriks-Hoogland ◽  
Anke Scheel-Sailer ◽  
...  
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Health Care Providers ◽  
Care Providers ◽  
Chronic Spinal Cord Injury ◽  
Cord Injury

scholarly journals A Primary Care Provider’s Guide to Accessibility After Spinal Cord Injury

2020 ◽  
Vol 26 (2) ◽  
pp. 79-84
Author(s):  
Joseph Lee ◽  
Jithin Varghese ◽  
Rose Brooks ◽  
Benjamin J. Turpen
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Primary Care Providers ◽  
Care Providers ◽  
Care Clinic ◽  
Care Services ◽  
Increased Risk ◽  
Cord Injury

Individuals with spinal cord injury (SCI) continue to have shorter life expectancies, limited ability to receive basic health care, and unmet care needs when compared to the general population. Primary preventive health care services remain underutilized, contributing to an increased risk of secondary complications. Three broad themes have been identified that limit primary care providers (PCPs) in providing good quality care: physical barriers; attitudes, knowledge, and expertise; and systemic barriers. Making significant physical alterations in every primary care clinic is not realistic, but solutions such as seeking out community partnerships that offer accessibility or transportation and scheduling appointments around an individual’s needs can mitigate some access issues. Resources that improve provider and staff disability literacy and communication skills should be emphasized. PCPs should also seek out easily accessible practice tools (SCI-specific toolkit, manuals, modules, quick reference guides, and other educational materials) to address any knowledge gaps. From a systemic perspective, it is important to recognize community SCI resources and develop collaboration between primary, secondary, and tertiary care services that can benefit SCI patients. Providers can address some of these barriers that lead to inequitable health care practices and in turn provide good quality, patient-centered care for such vulnerable groups. This article serves to assist PCPs in identifying the challenges of providing equitable care to SCI individuals.

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