Inpatient Migration Patterns In Persons With Spinal Cord Injury: A Registry Case Study With Hospital Discharge Data

Abstract:

This study investigated and compared patient migration patterns of persons with spinal cord injury, the general population and persons with morbid obesity, rheumatic conditions and bowel disease, for secondary health conditions, across administrative boundaries in Switzerland. The effects of patient characteristics and health conditions on visiting hospitals outside the residential canton were examined using complete, nationwide, inpatient health records for the year 2010 as well as 2011. Patients with spinal cord injury were more likely to obtain treatment outside their residential canton as compared to all other conditions. Facilitators of patient migration in persons with spinal cord injury and the general hospital population were private or accidental health insurances covering costs. Barriers of patient migration in persons with spinal cord injury were old age, severe multi-morbidity, financial coverage by basic health insurance, and minority language region.

Persons with spinal cord injury (SCI) experience a higher prevalence of chronic health conditions (e.g. heart disease, stroke, diabetes) than the general population and are at high risk of severe secondary conditions such as pneumonia, pressure ulcers or urinary tract infections. They were found to consult medical specialists more often than the general population, which was thought to lead to better management of the disease.

Maintaining the long-term health status of persons with SCI requires ongoing access to both general and specialist services. Because of the nature of their condition, persons with SCI are likely to experience problems with access to needed services. The World Health Organization (WHO) has recognised the need to improve healthcare access for individuals with disabilities. The respective WHO Action Plan presumes a profound understanding of the barriers that individuals with disabilities face with regard to accessing healthcare services. Hospital discharge data, which is readily available in many countries, can be used to study three dimensions of access to healthcare services defined by Penchansky and Thomas. Those are—availability, accessibility and affordability of required healthcare services.

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