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Murphy LF, Bryce TN, Coker J, Scott M, Roach MJ, Worobey L, Botticello AL. Medical, dental, and optical care utilization among community-living people with spinal cord injury in the United States. J Spinal Cord Med 2024; 47:64-73. [PMID: 35993789 PMCID: PMC10795619 DOI: 10.1080/10790268.2022.2110817] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
CONTEXT/OBJECTIVE Information about patterns of healthcare utilization for people living with spinal cord injury (SCI) is currently limited, and this is needed to understand independent community living after SCI. This study investigates self-reported healthcare utilization among community-living people with SCI and assesses disparities across demographic, socioeconomic, and injury-related subgroups. DESIGN Secondary analysis of cross-sectional survey data administered via telephone interview. SETTING 6 SCI Model Systems centers in the United States (California, Colorado, New Jersey, New York, Ohio, and Pennsylvania). PARTICIPANTS Adults with chronic, traumatic SCI who were community-living for at least one year after the completion of an inpatient rehabilitation program (N = 617). INTERVENTIONS Not applicable. OUTCOME MEASURES Utilization of a usual source of 4 types of health care in the past 12 months: primary, SCI, dental, and optical. RESULTS 84% of participants reported utilizing primary care in the past year. More than half reported utilizing SCI (54%) and dental (57%) care, and 36% reported utilizing optical care. There were no significant differences across key subgroups in the utilization of primary care. Participants who had been injured for 5 years or less and participants with greater educational attainment were more likely to report utilizing SCI care. Participants with higher household income levels were more likely to report using dental care. Female participants and older age groups were more likely to report using optical care. CONCLUSION Rates of healthcare utilization among people with SCI are below recommended rates and vary across demographic, socioeconomic, and injury-related subgroups. This information can inform future research to target barriers to using healthcare services among community-living people with SCI.
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Affiliation(s)
- Lauren F. Murphy
- Center for Spinal Cord Injury Research and Center for Outcomes and Assessment Research, Kessler Foundation, West Orange, New Jersey, USA
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Thomas N. Bryce
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Michael Scott
- Rancho Los Amigos National Rehabilitation Center, Downey, California, USA
| | - Mary Joan Roach
- Case Western Reserve University, Cleveland, Ohio, USA
- MetroHealth System, Cleveland, OH, USA
| | - Lynn Worobey
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Amanda L. Botticello
- Center for Spinal Cord Injury Research and Center for Outcomes and Assessment Research, Kessler Foundation, West Orange, New Jersey, USA
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
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Coker J, Sevigny M, Nguyen N, Battaglino R, Morse L. Factors Associated With Regular Dental Care in People With Spinal Cord Injury: A Secondary Analysis of Data From the FRASCI Study. Top Spinal Cord Inj Rehabil 2023; 29:71-79. [PMID: 38076285 PMCID: PMC10644853 DOI: 10.46292/sci22-00052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Background Oral health and regular dental care are critical to overall health. Research has found associations between oral health and infections, respiratory disease, and poor quality of life in the general population. While risks for all are increased in people with spinal cord injury (SCI), there is limited information on dental care after SCI. Objectives The purpose of this analysis was to examine factors associated with regular dental care in people with SCI. Methods We analyzed data from 348 individuals with traumatic and nontraumatic SCI who were enrolled in the Fracture Risk after SCI (FRASCI) study. The dataset included two variables on dental care, as well as demographics, injury-related characteristics, and secondary conditions. Bivariate relationships were determined using two-sided t tests and chi-square tests. Results Over 60% of the sample received regular dental care twice per year, and 71% reported seeing a dentist within the past year. Those participants receiving regular dental care twice a year were more likely to be female, be working, have more than a high school diploma, have private insurance, and need a caregiver compared to those who do not receive regular dental care. In addition, these participants were more likely to have had pneumonia since their SCI and have had a urinary tract infection in the past year and since injury. Conclusion More data on oral health are needed to make conclusions about the impact of oral health on secondary conditions and quality of life in people with SCI.
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Affiliation(s)
| | | | - Nguyen Nguyen
- Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Ricardo Battaglino
- Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Leslie Morse
- Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
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Warden A, Caldera K. The essential role of a physiatrist in recommending a COVID-19 vaccine. PM R 2021; 13:647-648. [PMID: 33644964 PMCID: PMC8013992 DOI: 10.1002/pmrj.12582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/15/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Alyssa Warden
- Department of Orthopedics & Rehabilitation Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Kristin Caldera
- Department of Orthopedics & Rehabilitation Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Blanco Belver A, Aach M, Schmiegel W, Schildhauer TA, Meindl R, Brechmann T. Similar Adenoma Detection Rates in Colonoscopic Procedures of Patients with Spinal Cord Injury Compared to Controls. Dig Dis Sci 2020; 65:1197-1205. [PMID: 31468268 DOI: 10.1007/s10620-019-05814-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/20/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Cancer is a major cause of death in patients with spinal cord injury (SCI). Preventive strategies, such as colonoscopy, deal with higher burdens that may lead to lower quality. AIMS The primary objective was to evaluate the adenoma detection rate. Secondary objectives were to investigate other quality indicators regarding bowel preparation, sedation, and endoscopy. METHODS Consecutive SCI patients who had undergone colonoscopy from 2003 to 2014 were assigned to a control group matched for age, gender, and year of procedure and reviewed retrospectively. RESULTS Bowel preparation lasted longer (3.6 ± 1.5 vs. 1.2 ± 0.6 days, p = 0.001), achieved unsatisfactory cleansing results more often (23.7 vs. 3.6%) and caused more adverse events in 236 SCI compared to 414 control patients. Colonoscopy needed a longer time (36.9 vs. 25.0 min) and remained incomplete more often (24.6 vs. 4.6%), resulting in more re-colonoscopies (14.8 vs. 4.3%). Endoscopy- and sedation-related adverse events were equal. However, neither overall nor size-dependent polyp (30.9 vs. 34.8%), adenoma (21.2 vs. 21.0%), advanced adenoma (6.8 vs. 7.2%), or cancer (1.7 vs. 2.0%) detection rates differed. CONCLUSION Despite intensified protocols, bowel preparation shows inferior results in SCI patients; colonoscopy needs more effort to succeed but achieves a comparable quality.
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Affiliation(s)
- Ana Blanco Belver
- Department of Gastroenterology and Hepatology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH, Ruhr-University Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Mirko Aach
- Department of General and Trauma Surgery, Spinal Cord Injury Unit, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH, Bochum, Germany
| | - Wolff Schmiegel
- Department of Gastroenterology and Hepatology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH, Ruhr-University Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
- Department of Medicine, Universitätsklinikum Knappschaftskrankenhaus Bochum GmbH, Bochum, Germany
| | - Thomas A Schildhauer
- Department of General and Trauma Surgery, Spinal Cord Injury Unit, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH, Bochum, Germany
| | - Renate Meindl
- Department of General and Trauma Surgery, Spinal Cord Injury Unit, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH, Bochum, Germany
| | - Thorsten Brechmann
- Department of Gastroenterology and Hepatology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH, Ruhr-University Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany.
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An introductory educational session improves medical student knowledge and comfort levels in caring for patients with physical disabilities. Disabil Health J 2020; 13:100825. [DOI: 10.1016/j.dhjo.2019.100825] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/24/2019] [Accepted: 07/21/2019] [Indexed: 11/21/2022]
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Deroche CB, McDermott SW, Mann JR, Hardin JW. Colorectal Cancer Screening Adherence in Selected Disabilities Over 10 Years. Am J Prev Med 2017; 52:735-741. [PMID: 28214250 DOI: 10.1016/j.amepre.2017.01.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 11/17/2016] [Accepted: 01/05/2017] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Colorectal cancer (CRC) is the second leading cause of cancer mortality in the U.S.; however, if the population aged 50 years or older received routine screening, approximately 60% of these deaths could be eliminated. This study investigates whether adults, aged 50-75 years, with one of three disabilities (blind/low vision [BLV], intellectual disability [ID], spinal cord injury [SCI]) receive CRC screening at rates equivalent to adults without the three disabilities, by accounting for combinations of recommended CRC screenings during a 10-year period (colonoscopy, sigmoidoscopy, fecal occult blood test). METHODS South Carolina Medicaid and Medicare, State Health Plan, and hospital discharge data (2000-2009) were analyzed (2013-2015) to estimate the proportion of adherence to and adjusted odds of CRC screening over time among adults with one of the three disabilities, BLV, ID, or SCI, versus adults without these conditions. RESULTS The estimated proportion of adults who adhere to changing recommendations over time was lower for adults with ID (34.32%) or SCI (44.14%) compared with those without these disabilities (48.48%). All three case groups had significantly lower AORs of adherence versus those without (BLV: AOR=0.88, 95% CI=0.80, 0.96; ID: AOR=0.55, 95% CI=0.52, 0.59; SCI: AOR=0.88, 95% CI=0.82, 0.95). CONCLUSIONS In this study, adults with BLV, ID, or SCI were less likely to receive and adhere to CRC screening recommendations than those without these disabilities. This method provides a thorough evaluation of adherence to CRC screening by considering levels of adherence during each month of Medicaid or Medicare coverage.
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Affiliation(s)
- Chelsea B Deroche
- Department of Health Management and Informatics, Biostatistics and Research Design Unit, University of Missouri School of Medicine, Columbia, Missouri.
| | - Suzanne W McDermott
- Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia, South Carolina
| | - Joshua R Mann
- Department of Preventive Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - James W Hardin
- Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia, South Carolina
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Ho CH. Primary care for persons with spinal cord injury - not a novel idea but still under-developed. J Spinal Cord Med 2016; 39:500-3. [PMID: 27463240 PMCID: PMC5020592 DOI: 10.1080/10790268.2016.1182696] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Primary care for persons with spinal cord injury (SCI) has long been recognized as an important issue. Over the last two decades, there has not been any consensus on its contents, pathway or delivery model. Despite the lack of attention on this issue, various health care organizations and settings have successfully developed their own version of primary care for persons with SCI. On the other hand, persons with SCI have also found different ways to obtain primary care through Family Physicians and specialists, often depending on the health care structure of their country. This has blurred the line between what is traditionally seen as primary vs. specialist care. The "medical home" model may be ideal for SCI primary care, and it may be establishsed in different care settings. In order to create this model, health care funding structure, appropriate access to physical facility and SCI knowledge, interdisciplinary provider availability and collaboration, as well as active engagement with persons with SCI are necessary. The SCI community should endorse SCI primary care with effective advocacy and implementation.
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Affiliation(s)
- Chester H. Ho
- Correspondence to: Chester H. Ho, Foothills Hospital, Room 1195D, 1403-29th Street NW, Calgary, AB, T2N 2T9, Canada.
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