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

Spinal Cord. 2021 Apr;59(4):381-388. doi: 10.1038/s41393-020-00581-6. Epub 2020 Nov 13.

Abstract

Study design: Cross-sectional observational study using data from the second community survey of the Swiss Spinal Cord Injury Cohort Study (Survey 2017) conducted between 03/2017 and 03/2018.

Objectives: To identify facilitators of and barriers to utilizing SCI-specialized outpatient clinic and inpatient care by individuals with spinal cord injury (SCI).

Setting: Community.

Methods: Multivariable logistic regression was used to identify factors influencing (1) the attendance at annual check-ups at SCI-specialized treatment facilities, (2) the utilization of SCI-specialized outpatient clinic care by those who utilized any outpatient clinic care, and (3) the utilization of SCI-specialized inpatient care by those who were hospitalized. Multiple imputation was used to account for missing data.

Results: Out of 3959 eligible individuals, 1294 completed the questionnaire (response rate 33%). In the last 12 months, 51% of study participants attended the annual check-up, 33% of outpatient clinic care users utilized SCI-specialized outpatient clinic care, and 44% of those who were hospitalized were hospitalized at a SCI center. Annual check-ups were attended less by women, the elderly, and those with nontraumatic SCI. SCI-specialized outpatient clinic care was less likely to be utilized when individuals with SCI were living with cancer, lived farther away from SCI-specialized treatment facilities or in a minority language region. Specialized inpatient care was less likely to be utilized by women and those with incomplete lesions.

Conclusions: SCI-specialized outpatient clinic care must be provided near the residence of individuals with SCI, otherwise non-specialized care is utilized. The reasons why women utilize SCI-specialized care less frequently than men merits further investigation.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Ambulatory Care
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Patient Acceptance of Health Care
  • Spinal Cord Injuries* / epidemiology
  • Spinal Cord Injuries* / therapy