University of Washington

Department of Rehabilitation Medicine

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Examining health-care utilization in the first year following spinal cord injury


Skelton F, Hoffman JM, Reyes M, Burns SP



Publication Info:

The Journal of Spinal Cord Medicine, Epub ahead of print 10/2014:


One hundred sixty-eight patients were enrolled and followed by telephone follow-up questionnaires at three, six, nine and 12 months after discharge from an SCI Model System inpatient rehabilitation (IR) program. Participants were grouped according to the American Spinal Cord Injury Association (ASIA) impairment scale (AIS): C1-4, AIS A-C; C5-C8 AIS A-C, paraplegia AIS A-C, and all AIS D. This study looked at how much hospital care, outpatient visits, and home services the participants used during the first year after IR. Forty-five percent of subjects were hospitalized in the first year. Twenty percent were initially discharged to a skilled nursing facility (SNF), and an additional 10% required SNF care during the first year. Overall, those with C1-4 AIS A-C used the most health care services. Participants discharged home after IR used less health care than those who went elsewhere after discharge. Individuals who had SCI due to falls needed fewer in-home service visits than those who were injured in vehicular crashes. Age, sex, race, and education were unrelated to higher use. The authors conclude that focusing on reducing genitourinary and respiratory complications may reduce the need for hospital care in the first year after IR.

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