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Quality of care indices AND spinal cord injury

Michael A Bohl, Jacob F Baranoski, Daniel Sexton, Peter Nakaji, Laura A Snyder, U Kumar Kakarla, Randall W Porter
OBJECTIVE: The Barrow Innovation Center comprises an educational program in medical innovation that enables residents to identify problems in patient care and rapidly develop and implement solutions to these problems. Residents involved in this program noted an elevated risk of iatrogenic spinal cord injury during posterior cervical and thoracic procedures. The objective of this study was to describe this complication, and a novel solution was developed through a new innovation training program...
December 2018: World Neurosurgery
Elias Ronca, Anke Scheel-Sailer, Hans Georg Koch, Stefan Essig, Mirjam Brach, Nadja Münzel, Armin Gemperli
OBJECTIVE: To identify barriers to access healthcare services and reveal determinants of satisfaction with healthcare services in people with chronic spinal cord injury (SCI). DESIGN: Cross-sectional survey. SETTING: Community setting in Switzerland. PARTICIPANTS: People with chronic SCI. INTERVENTIONS: Non-applicable. OUTCOME MEASURES: Questionnaire-based evaluation of availability and quality of healthcare services for secondary health conditions, satisfaction with fulfillment of healthcare needs, and preference for care from a hypothetical service provider with limited specialized SCI care expertise but in close proximity over comprehensive care from an existing specialized SCI center located at a greater distance...
July 2, 2018: Journal of Spinal Cord Medicine
Marc Le Fort, Maude Espagnacq, Thierry Albert, Chloë Lefèvre, Brigitte Perrouin-Verbe, Jean-François Ravaud
Background: Pressure ulcer risk assessment provides an indicator of quality of care in French health establishments. The reliability and validity of assessment tools have been shown to be lower for people with spinal cord injury (SCI). We hypothesized that skin complications would be less frequent in people with traumatic SCI and tetraplegia (TSCIt), who were initially managed in French regions with a high level of specialized SCI rehabilitation experience. Methods: First, we used the most recent French territorial survey about SCI to determine a 'Level of Regional Experience (LRE) in Specialized Physical Medicine and Rehabilitation'...
December 1, 2018: European Journal of Public Health
Jeanette P Brown, Kristy A Bauman, Armando Kurili, Gianna M Rodriguez, Anthony E Chiodo, Robert G Sitrin, Helena M Schotland
STUDY DESIGN: Prospective, cohort study. OBJECTIVES: To evaluate the effectiveness of bi-level positive airway pressure (PAP) therapy and the patterns of use for sleep-disordered breathing (SDB) in individuals with spinal cord injury (SCI). SETTING: Academic tertiary care center, USA. METHODS: Overall, 91 adults with C1-T6 SCI for ≥3 months were recruited and 74 remained in the study to be evaluated for SDB and follow-up...
August 2018: Spinal Cord
Muna Bhattarai, Khomapak Maneewat, Wipa Sae-Sia
BACKGROUND: One of many types of injuries following an earthquake is spinal cord injury (SCI) which is a life-long medically complex injury and high-cost health problem. Despite several negative consequences, some persons with SCI are resilient enough to achieve positive adjustment, greater acceptance, and better quality of life. Since resilience is influenced by several factors and can vary by context, it is beneficial to explore factors that affect the resilience of people who sustained spinal cord injury from the 2015 earthquake in Nepal...
March 2, 2018: BMC Psychiatry
Apeksha Chaturvedi, Abhishek Chaturvedi, A Luana Stanescu, Johan G Blickman, Steven P Meyers
Mechanical birth-related injuries to the neonate are declining in incidence with advances in prenatal diagnosis and care. These injuries, however, continue to represent an important source of morbidity and mortality in the affected patient population. In the United States, these injuries are estimated to occur among 2.6% of births. Although more usual in context of existing feto-maternal risk factors, their occurrence can be unpredictable. While often superficial and temporary, functional and cosmetic sequelae, disability or even death can result as a consequence of birth-related injuries...
February 2018: Insights Into Imaging
Cynthia M Tse, Amanda E Chisholm, Tania Lam, Janice J Eng
CONTEXT: Impaired balance function after a spinal cord injury (SCI) hinders performance of daily activities. OBJECTIVE: To assess the evidence on the effectiveness of task-specific training on sitting and standing function in individuals with SCI across the continuum of care. METHODS: A systematic search was conducted on literature published to June 2016 using people (acute or chronic SCI), task-specific interventions compared to conventional physical therapy, and outcome (sitting or standing balance function)...
May 2018: Journal of Spinal Cord Medicine
Michael G Fehlings, Christiana L Cheng, Elaine Chan, Nancy P Thorogood, Vanessa K Noonan, Henry Ahn, Christopher S Bailey, Anoushka Singh, Marcel F Dvorak
In today's economic climate, there is a need to demonstrate a return on investment for healthcare spending and for clinical practice and policy to be informed by evidence. Navigating this process is difficult for decision-makers, clinicians, and researchers alike. This article will describe how a knowledge translation framework and an evidence-based policy-making process were integrated to clarify the problem, frame options, and plan implementation, to impact clinical practice and policy in the area of traumatic spinal cord injury (tSCI)...
October 15, 2017: Journal of Neurotrauma
Hannah Tough, Martin W Brinkhof, Johannes Siegrist, Christine Fekete
OBJECTIVE: To explore the effect of relationship quality and reciprocity in partnerships on subjective caregiver burden and caregiver satisfaction in partners of persons with a severe physical disability (spinal cord injury). DESIGN: Cross-sectional, observational. SETTING: Community setting. PARTICIPANTS: Caregiving partners of persons with spinal cord injury (N=118). INTERVENTIONS: Not applicable...
October 2017: Archives of Physical Medicine and Rehabilitation
Diana Pacheco, Mirja H Gross-Hemmi
OBJECTIVE: The Learning Health System for Spinal Cord Injury (LHS-SCI) is an initiative aligned with the World Health Organization's (WHO) Global Disability Action Plan. Based on the outcomes of this initiative, countries will be able to shape their health systems to better respond to the needs of persons with SCI. This paper describes and compares the macroeconomic situation and societal response to SCI across 27 countries from all 6 WHO regions that will participate in the LHS-SCI initiative...
February 2017: American Journal of Physical Medicine & Rehabilitation
C Guillot-Tantay, E Chartier-Kastler, Q Manach, M-A Perrouin-Verbe, P Denys, V Phé
INTRODUCTION: To provide an overview of the urological management of spinal cord injured patients based on an economic analysis. MATERIALS AND METHODS: A literature search from January 1994 to December 2014 was performed using Medline and Embase database using the following keywords: cost-effectiveness; cost-benefit; cost-utility; spinal cord injury; neurogenic bladder; intermittent catheterization; antimuscarinics; botulinum toxin; sacral neuromodulation; tibial nerve; Brindley; sphincterotomy...
January 2017: Progrès en Urologie
Yvonne Anne Michel, Lidia Engel, Kim Rand-Hendriksen, Liv Ariane Augestad, David Gt Whitehurst
BACKGROUND: In health economic analyses, health states are typically valued using instruments with few items per dimension. Due to the generic (and often reductionist) nature of such instruments, certain groups of respondents may experience challenges in describing their health state. This study is concerned with generic, preference-based health state instruments that provide information for decisions about the allocation of resources in health care. Unlike physical measurement instruments, preference-based health state instruments provide health state values that are dependent on how respondents interpret the items...
November 28, 2016: Health and Quality of Life Outcomes
Neel K Patel, Rachel A Moses, Brook I Martin, Jon D Lurie, Sohail K Mirza
STUDY DESIGN: Retrospective analysis of patients undergoing elective lumbar fusion operations, comparing rates of repeat spine surgery based on method of ascertainment. OBJECTIVE: We report the accuracy of a claims-based approach for reporting repeat surgery compared with medical records abstraction as the "gold standard." SUMMARY OF BACKGROUND DATA: Previous studies have reported the validity of a claims-based algorithm for grouping patients by surgical indication and classifying operative features, but their accuracy in measuring surgical quality indicators has not been widely examined...
May 1, 2017: Spine
Ibrahim Gundogdu, Erhan Arif Ozturk, Ebru Umay, Ozgur Zeliha Karaahmet, Ece Unlu, Aytul Cakci
PURPOSE: Following repeated weaning failures in acute care services, spinal cord injury (SCI) patients who require prolonged mechanical ventilation and tracheostomy are discharged to their homes or skilled nursing facilities, with a portable mechanical ventilator (MV) and/or tracheostomy tube (TT) with excess risk of complications, high cost and low quality of life. We hypothesized that many difficult-to-wean patients with cervical SCI can be successfully managed in a rehabilitation clinic...
June 2017: Disability and Rehabilitation
Julio C Furlan, Beverly Catharine Craven, Michael G Fehlings
BACKGROUND: Aging of the population has modified the epidemiology of traumatic spinal cord injury (SCI) as evidenced by the establishment of a bimodal distribution of injuries with increased frequency of fall-related injuries among the elderly. OBJECTIVE: To assess the economic impact of older age (65 years of age and older), using a cost-utility analysis, in the context of acute surgical management and rehabilitation of traumatic cervical SCI, given the paucity of economic studies involving elderly individuals with SCI...
September 2016: Neurosurgery
Zee-A Han, Dae Heon Song, Hyun-Mi Oh, Myung Eun Chung
OBJECTIVE: To evaluate the analgesic effect of botulinum toxin type A (BTX-A) on patients with spinal cord injury-associated neuropathic pain. METHODS: The effect of BTX-A on 40 patients with spinal cord injury-associated neuropathic pain was investigated using a randomized, double-blind, placebo-controlled design. A 1-time subcutaneous BTX-A (200U) injection was administered to the painful area. Visual analogue scale (VAS) scores (0-100mm), the Korean version of the short-form McGill Pain Questionnaire, and the World Health Organization WHOQOL-BREF quality of life assessment were evaluated prior to treatment and at 4 and 8 weeks after the injection...
April 2016: Annals of Neurology
Julio C Furlan, B Catharine Craven, Eric M Massicotte, Michael G Fehlings
OBJECTIVE: This cost-utility analysis was undertaken to compare early (≤24 hours since trauma) versus delayed surgical decompression of spinal cord to determine which approach is more cost effective in the management of patients with acute traumatic cervical spinal cord injury (SCI). METHODS: This study includes the patients enrolled into the Surgical Timing in Acute Spinal Cord Injury Study (STASCIS) and admitted at Toronto Western Hospital. Cases were grouped into patients with motor complete SCI and individuals with motor incomplete SCI...
April 2016: World Neurosurgery
Victor Chang, Jason M Schwalb, David R Nerenz, Lisa Pietrantoni, Sharon Jones, Michelle Jankowski, Nancy Oja-Tebbe, Stephen Bartol, Muwaffak Abdulhak
OBJECT Given the scrutiny of spine surgery by policy makers, spine surgeons are motivated to demonstrate and improve outcomes, by determining which patients will and will not benefit from surgery, and to reduce costs, often by reducing complications. Insurers are similarly motivated. In 2013, Blue Cross Blue Shield of Michigan (BCBSM) and Blue Care Network (BCN) established the Michigan Spine Surgery Improvement Collaborative (MSSIC) as a Collaborative Quality Initiative (CQI). MSSIC is one of the newest of 21 other CQIs that have significantly improved-and continue to improve-the quality of patient care throughout the state of Michigan...
December 2015: Neurosurgical Focus
Samford Wong, Ali Jamous, Jean O'Driscoll, Ravi Sekhar, Mofid Saif, Steve O'Driscoll, Sarah Lewis, Eamonn McKeown, Shashi P Hirani
BACKGROUND: Probiotics may prevent antibiotic-associated and Clostridium difficile-associated diarrhoea (AAD/CDAD). Many spinal cord injury centre (SCIC) practitioners consider probiotics generically and may not realise that efficacy can be strain-, dose- and disease-specific. In order to confirm these effects and fully evaluate the extent of probiotic effectiveness in these patients, a systematic review and meta-analysis is indicated. METHODS: The following databases will be searched for relevant studies: Cochrane Library; Centre for Reviews and Dissemination (CRD) Database; CINAHL; PsycINFO; Embase; Medline; AMED; International Clinical Trials Registry Platform Search Portal and ISRCTN Registry and will hand search a list of conference proceedings...
2015: Systematic Reviews
D J Hoh, M Rahman, K M Fargen, D Neal, B L Hoh
STUDY DESIGN: A retrospective national administrative database study. OBJECTIVE: Patient safety indicators (PSIs) and hospital-acquired conditions (HACs) are metrics for quality of health care and are linked to reimbursement. The prevalence of PSIs/HACs may impact access to health care for certain conditions. We estimated the national occurrence rates of PSIs/HACs among cervical trauma patients and identified patient factors that correlate with their occurrence...
April 2016: Spinal Cord
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