Decreasing re-hospitalizations and emergency department visits in persons with recent spinal cord injuries using a specialized medical home

Ruediger, Marci; Kupfer, Mendel; Leiby, Benjamin E.

doi:10.1080/10790268.2019.1671075

Cited by 8 publications

(6 citation statements)

References 13 publications

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“…39 To meet the post-rehabilitation needs of persons with SCI it was proposed that an integrated system of healthcare that extends into the community and focuses on greater integration during post-rehabilitation care must be developed. 39 Other articles described the role and importance of primary care [40][41][42][43] and the patient-centered medical home concept 44,45 in the delivery of SCI care in the community. Taking a patient-centered delivery of care approach, two articles described patients being active and informed partners in their care planning and independently manage their own care based on their unique needs and individual preferences.…”

Section: Descriptions Of the State Of Sci Carementioning

confidence: 99%

“…Taking a patient-centered delivery of care approach, two articles described patients being active and informed partners in their care planning and independently manage their own care based on their unique needs and individual preferences. 44,45 Methods to evaluate models of care Two articles outlined methods to evaluate or simulate patient care across the care continuum and described how the impact of interventions or innovations across the continuum of care could be predicted or evaluated before they are implemented. 46,47 Both articles were part of the Access to Care and Timing (ACT) project in Canada, which aimed to model the systems of delivery and simulate, predict, and evaluate interventions.…”

Section: Descriptions Of the State Of Sci Carementioning

confidence: 99%

“…When comparing the two different models of long-term personal assistance care, it was found that the group that used self-managed care received more hours of paid assistance and experienced more positive outcomes such as better life satisfaction, better health outcomes, and lower costs. 50 Recognizing the complexity of the medical issues related to SCI, specialized home-based models of care have been reported in order to decrease hospital readmission and emergency department visits, 45 and to allow for early discharge and prevent re-admission. 51 A number of articles have proposed the inclusion of additional team members, such as peer mentors, as part of this multidisciplinary team structure, as evidenced by their benefits.…”

Section: Current and Proposed Models Of Carementioning

confidence: 99%

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Models of Care Delivery from Rehabilitation to Community for Spinal Cord Injury: A Scoping Review

Atchison

Noonan

et al. 2021

Journal of Neurotrauma

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Spinal cord injury (SCI) is a chronic condition that results in high healthcare utilization and lifetime cost across the care continuum. In the absence of a standardized model of care delivery for SCI in western countries such as Canada, a scoping review of the literature was performed to identify and summarize existing international SCI models of care delivery. Four databases were searched using key words and subject headings for concepts such as: ''spinal cord injury,'' ''delivery of healthcare,'' ''model of care,'' ''patient care planning,'' and ''care pathway.'' Title, abstract, and full text review were competed by two independent reviewers. A combined total of 46 peer-reviewed and gray literature articles were included. No single SCI model of care has been adopted across different countries internationally. However, optimal attributes of models of care were identified, including the importance of having multidisciplinary SCI specialty care providers along the continuum, provision of rural SCI services and outreach, integration of primary care, peer mentoring, and using a hub and spokes model of care. These findings inform the future development of an SCI model of care, which ideally would serve all geographical locations and span the continuum of care, improving the health status and quality of life of persons with SCI.

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Section: Descriptions Of the State Of Sci Carementioning

confidence: 99%

Section: Descriptions Of the State Of Sci Carementioning

confidence: 99%

Section: Current and Proposed Models Of Carementioning

confidence: 99%

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Models of Care Delivery from Rehabilitation to Community for Spinal Cord Injury: A Scoping Review

Atchison

Noonan

et al. 2021

Journal of Neurotrauma

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“…After the acute period of the disease, community-based services are necessary for many SCI patients during the recovery period and after acquiring partial recovery. If the patient fails to receive appropriate out-of-hospital care, he/she may need re-hospitalization [ 10 ]. The positive consequences of using home care services include a reduction in financial costs and need for hospital-based care and an increase in social participation and patient satisfaction, highlighting the unique role of home care services in today’s world.…”

Section: Introductionmentioning

confidence: 99%

Exploring caregivers’ perceptions of community-based service requirements of patients with spinal cord injury: a qualitative study

Galehdar

Heydari

2023

BMC Prim. Care

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Background The incidence of spinal cord injury is increasing worldwide. Patients with spinal cord injury and their families face many difficulties during the disease course. Caregivers are more involved with these patients than anyone else, so recognizing patients’ care requirements based on caregivers’ opinions can facilitate care provision to these people. The purpose of this study was to explore caregivers’ perceptions of the community-based services requirements of patients with spinal cord injury. Methods This qualitative research was conducted in Iran from Apr 2021 to Dec 2022 using the conventional content analysis method. The participants in the study included family caregivers and providers of home care services to patients with spinal cord injury, who were selected by purposeful sampling. Data were collected by conducting 14 face-to-face interviews and analyzed based on the method proposed by Lundman and Graneheim. Results Data analysis led to the extraction of 815 primary codes, which were organized into two themes: community reintegration (with two categories, including the need to provide a suitable social platform and lifelong care) and palliative care (with two categories, including family conference and survival management). Conclusion Social facilities and infrastructure should be modified in a way that patients with spinal cord injury can appropriately benefit from community-based care services and an independent satisfactory life. Palliative care should be continuously provided from the time of lesion development until the patient’s death.

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“…The boundaries between professional home care and informal care are blurred, and it is unclear who the typical user of professional home care is. The few international studies available examine the effect of speci c home care programs on hospitalization and emergency department use [12][13][14][15][16], or costs [11,17], offering little insight into the use of professional home care in persons with SCI. In Switzerland, Huang et al [18,19] investigated professional home care in persons with SCI exclusively from the perspective of family caregivers.…”

mentioning

confidence: 99%

Use of professional home care in persons with spinal cord injury in Switzerland: A cross-sectional study

Wagner

Brach

Scheel‐Sailer

et al. 2023

Preprint

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Background Persons with spinal cord injury (SCI) living in the community often require care. The boundaries between professional home care and informal care are blurred, and it is unclear who the typical user of home care is. The objective of this study was to describe the characteristics of persons with SCI using professional home care in Switzerland, determine the frequency of home care visits, and investigate the association of sociodemographic factors, SCI-specific characteristics, secondary health conditions, and functional independence with the use of home care. Methods We used cross-sectional data from the 2017 community survey of the Swiss Spinal Cord Injury Cohort Study (SwiSCI). Out of 3,959 eligible individuals 1294 completed the questionnaire and were included in the analysis (response rate 33%). Using descriptive statistics, differences between home care users and non-users as well as the frequency of home care visits were investigated. The association between sociodemographic factors, SCI-specific characteristics, secondary health conditions, functional independence and the use of home care was analyzed using multivariable logistic regression. Multiple imputation was used to account for missing data. Results Of 1,294 participants, 280 (22%) used professional home care. The median hours of professional home care received per week was 6 hours (Q1 = 2, Q3 = 12). More home care was used in persons with lower functional independence (Odds ratio (OR) 0.30 per 10 unit decrease in the Spinal Cord Independence Measure (SCIM-SR), 95%-Confidence interval (CI) 0.24–0.37), fewer secondary health conditions (OR 0.96 per unit SCI-SCS, 95%-CI 0.94–0.99), tetraplegia (OR 2.77, 95%-CI 1.92-4.00), women (OR 2.42, 95%-CI 1.70–3.43), higher age (OR 1.22 per 10 years increase, 95%-CI 1.06–1.39), living alone (OR 2.48, 95%-CI 1.53–4.03), and those receiving support from an informal caregiver (OR 1.88, 95%-CI 1.27–2.77). Conclusions This is the first study to examine the use of professional home care from the perspective of persons with SCI in Switzerland. Functional independence was found to be a strong predictor of home care use. The findings showed that professional home care complements informal care and is more likely to be used by individuals with SCI who live alone, have tetraplegia, and are female.

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Decreasing re-hospitalizations and emergency department visits in persons with recent spinal cord injuries using a specialized medical home

Cited by 8 publications

References 13 publications

Models of Care Delivery from Rehabilitation to Community for Spinal Cord Injury: A Scoping Review

Models of Care Delivery from Rehabilitation to Community for Spinal Cord Injury: A Scoping Review

Exploring caregivers’ perceptions of community-based service requirements of patients with spinal cord injury: a qualitative study

Use of professional home care in persons with spinal cord injury in Switzerland: A cross-sectional study

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