Spinal Cord Injury
Health Services Research
To 1) identify the self-reported prevalence of seven chronic health conditions (CHCs) in adults with chronic, traumatic spinal cord injury (SCI), 2) examine the relationships between the presence of CHC with future hospital admissions and total number of inpatient days and 3) identify predictors of utilization.
Design : Retrospective analysis of self-report and administrative billing data.
Setting : Data were collected from participants living in and utilizing non-federal hospitals in South Carolina, USA.
Participants (or Animals, Specimens, Cadavers):
Participants were identified through the population-based South Carolina SCI Surveillance System Registry. Between 2010 and 2013, 963 adults (> 18 years old) with chronic (> 1-year), traumatic SCI volunteered to complete self-report assessments (SRAs); data from 787 individuals were included in this analysis.
Interventions : Not Applicable
Main Outcome Measure(s):
The presence/absence of seven CHC, including diabetes, heart attack, coronary heart disease, stroke, hypertension, high cholesterol and cancer, was assessed using self-report data. Administrative billing data were used to assess hospital utilization (hospital admissions and total number of inpatient days) in non-federal, South Carolina hospitals in the year following the SRA.
Results : Of the 787 participants, 40.5% reported no CHC; 23.4% reported one CHC and 36.1% reported having two or more CHC. The most commonly reported CHCs were hypertension (43.1%), high cholesterol (32.2%) and diabetes (15.8%). In total, 59% had at least one hospital admission in the year following the SRA (mean 3 ± 5; range 0-45; median = 1). The mean total inpatient days was 15.7 ± 43 days (range 0-365; median = 1). Predictors of hospital admission included CHC, pressure sores, education, prior hospitalization and injury severity. With the exception of CHC, each was also associated with total number of inpatient days.
Conclusions : CHC are prevalent and associated with hospital admissions in adults with chronic, traumatic SCI.