Healthcare utilization varies among people with spinal cord injury

Eastern Hanover, NJ. November 18, 2022. A survey of people with spinal cord injury living in the community found health care utilization below recommended rates for four types of care: primary care, spinal cord injury, dental and optical care. The researchers also found disparities associated with demographic, socioeconomic and injury-related characteristics. The article “Use of medical, dental, and optical care among community-dwelling individuals with spinal cord injury in the United States” (doi: 10.1080/10790268.2022.2110817) was published online by the Journal of Spinal Cord Medicine on August 22, 2022.

The authors are Lauren F. Murphy, Thomas N. Bryce, Jennifer Coker, Michael Scott, Mary Joan Roach, Lynn Worobey and Amanda Botticello. The team collaborated on a secondary analysis of survey data collected by Spinal Cord Injury Model Systems (SCIMS) in California, Colorado, New Jersey, New York, Ohio and Pennsylvania. SCIMS centers are federally funded through the National Institute for Disability, Independent Living and Rehabilitation Research, Administration for Community Living, US Department of Health and Human Services.

A total of 690 participants completed the survey, answering questions about their use of routine services from primary care, spinal cord injury, dental and optical providers over the previous 12 months. Injury-related variables included level and type of injury, time since injury, and wheelchair/scooter use. Demographic factors included age, gender, race/ethnicity, education, and household income. Health-related variables included self-reports from health insurance, secondary complications, and chronic conditions in the past 12 months.

Although the survey found relatively high rates of health care utilization, dental and optical care was available at lower rates than reported in the general population, and there were socioeconomic disparities between groups. , according to lead author Lauren Murphy, PhD, of the Kessler Foundation. Dr Murphy explained: “This finding may suggest unmet needs in people with spinal cord injury and the need to examine barriers to care, including inadequate finances or insurance coverage, as well as lack of trained providers and accessibility issues.

Although people with spinal cord injuries see primary care providers at about the same rate as the general population – 84% – because of their potential for complications, more frequent primary care visits may be warranted. “More than half of participants have seen a spinal cord injury care specialist in the past year,” Dr. Murphy added. “This group was more likely to be injured for less than five years and to have a post-secondary education. Seeing a specialist trained in the management of chronic spinal cord injury can potentially maximize opportunities for independent living, so it is important to examine how people choose the type of provider they see for routine care.

The study provides a useful perspective on how people with spinal cord injuries meet their health care needs. “Information on health care utilization for this population is limited,” said co-author Amanda Botticello, PhD, MPH, of the Kessler Foundation, “especially for ancillary services such as dental and optical care. Increasing our understanding of health care utilization is an important first step towards research that aims to fill gaps in care Reducing barriers will lead to better care for chronic diseases, prevention of medical complications secondary and better outcomes for this population.

Funding sources: Craig H. Neilsen Foundation [#639798]; National Institute on Disability, Independent Living, and Rehabilitation Research as part of the Northern New Jersey Spinal Cord Injury System [#90SI5026-01-00].