Emergency Department Visits,Related Hospitalizations,and Reasons for Emergency Department Utilization After Traumatic Spinal Cord Injury |
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| Affiliation: | 1. College of Health Professions, Medical University of South Carolina, Charleston, SC;2. Shepherd Center, Atlanta, GA;1. From the Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA;2. Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA;3. Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA;4. Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA;5. Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Nova Scotia, Canada;6. Department of Physical Medicine & Rehabilitation, University of Alabama, Birmingham, AL;7. Kessler Foundation, West Orange, NJ;8. Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ;9. Kessler Institute for Rehabilitation, West Orange, NJ;10. Feinberg School of Medicine, Northwestern University, Chicago, IL;11. Shirley Ryan Ability Lab, Chicago, IL;1. Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA;2. Departments of Physical Medicine and Rehabilitation;3. Bioengineering;4. Physical Therapy;5. Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA;6. University of Pittsburgh Medical Center Centers for Rehab Services, Pittsburgh, PA;7. Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL;8. Department of Human Performance and Sport Studies, Idaho State University, Pocatello, ID;1. Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA;2. Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA;3. Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA;4. Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA;5. Rehabilitation Science and Technology, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA;6. Department of Physical Medicine and Rehabilitation, University of Alabama, Birmingham, AL;7. Feinberg School of Medicine, Northwestern University, Chicago, IL;8. Shirley Ryan Ability Lab, Chicago, IL;9. Kessler Foundation, West Orange, NJ;10. Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ;1. Biostatistics & Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA;2. Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA;3. Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA;5. Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL;6. Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA;1. College of Health Professions, Medical University of South Carolina, Charleston, SC;2. Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA;3. Department of Psychiatry, University of California, San Diego, La Jolla, CA;1. Craig Hospital, Englewood, CO;2. Kessler Foundation, West Orange, NJ;3. Icahn School of Medicine at Mount Sinai, New York, NY;4. Shirley Ryan AbilityLab, Chicago, IL;5. Spaulding Rehabilitation Hospital, Charlestown, MA;6. University of Minnesota Medical School, Minneapolis, MN;7. Texas Institute for Rehabilitation Research, Houston, TX |
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| Abstract: | ObjectiveTo identify the self-reported frequency of emergency department (ED) visits, ED-related hospitalizations, and reasons for ED visits among people with traumatic spinal cord injury (SCI) and compare them with general population data from the same geographic area.DesignCross-sectional.SettingA specialty hospital in the Southeastern United States.ParticipantsThe participants (N=648) were community-dwelling adults (18 years and older) with a traumatic SCI, who were at least 1 year postinjury. A comparison group of 9728 individuals from the general population was retrieved from the 2017 National Health Interview Survey (NHIS).InterventionsNot applicable.Main Outcome MeasuresParticipants completed self-report assessments on ED visits, ED hospitalizations, and reasons for ED visits in the past 12 months using items from the NHIS.ResultsA total of 37% of participants with SCI reported at least 1 ED visit, and 18% reported at least 1 ED hospitalization in the past 12 months. Among those having at least 1 ED visit, 49% were admitted to hospitals. After controlling for sex, age, and race/ethnicity, participants with SCI were 151% more likely to visit the ED (odds ratio [OR], 2.51) and 249% more likely to have at least 1 ED hospitalization than the NHIS sample (OR, 3.49). Persons with SCI had a higher percentage of ED visits because of severe health conditions, reported an ED was the closest provider, and were more likely to arrive by ambulance. NHIS participants were more likely to visit the ED because no other option was available.ConclusionsCompared with those in the general population, individuals with SCI have substantially higher rates of ED visits, yet ED visits are not regularly assessed within the SCI Model Systems. ED visits may indicate the need for intervention beyond the acute condition leading directly to the ED visits and an opportunity to link individuals with resources needed to maintain function in the community. |
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