College of Health Professions, Medical University of South Carolina, Charleston, South Carolina, USA.
Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
J Spinal Cord Med. 2024 Nov;47(6):1007-1015. doi: 10.1080/10790268.2023.2234726. Epub 2023 Oct 11.
To identify differences in personal characteristics, health outcomes, and hospital utilization as a function of ambulatory status among adults with chronic SCI. Prospective cohort study linked to state administrative billing data. Population-based SCI Registry from the Southeastern United States. 1,051 adults (>18 years old) with chronic (>1-year), traumatic SCI. The self-report assessment (SRA) included demographic, injury and disability characteristics, health status, psychological and behavioral factors, and participation and quality of life (QOL) variables. We linked cases to administrative billing data to assess hospital utilization, including Emergency Department (ED) visits and inpatient (IP) admissions (through the ED and direct IP) in non-federal state hospitals within the year following the SRA. There were 706 ambulatory and 345 non-ambulatory participants. We found significant differences across all sets of factors and significant differences in hospital utilization metrics. Ambulatory adults had fewer ED visits (36% vs 44%), IP admissions through the ED (11% vs 25%) and IP only admissions (9% vs 19%) and spent fewer days in the hospital for both admissions through the ED (0.9 vs 4.6 days) and IP only admissions (0.7 vs 3.1 days). They also reported having fewer past year ED visits (44% vs 62%) and IP admissions (34% vs 52%). We identified differences in personal characteristics, ED visits and IP admissions between ambulatory and non-ambulatory adults with SCI, providing a better understanding of the characteristics of those with SCI. The findings suggest the need for separate analyses based on ambulatory status when assessing long-term health outcomes including hospital utilization.
为了确定慢性 SCI 成人的门诊状态与个人特征、健康结果和医院利用之间的差异。前瞻性队列研究与州行政计费数据相关联。来自美国东南部的基于人群的 SCI 登记处。1051 名（>18 岁）患有慢性（>1 年）、创伤性 SCI 的成年人。自我报告评估（SRA）包括人口统计学、损伤和残疾特征、健康状况、心理和行为因素以及参与和生活质量（QOL）变量。我们将病例与行政计费数据相关联，以评估当年 SRA 后在非联邦州立医院的急诊部（ED）就诊和住院（通过 ED 和直接 IP）的住院利用情况。有 706 名门诊和 345 名非门诊参与者。我们发现所有因素组之间存在显著差异，并且在医院利用指标方面存在显著差异。门诊成年人的 ED 就诊次数（36%对 44%）、通过 ED 的 IP 入院（11%对 25%）和仅 IP 入院（9%对 19%）以及 ED 就诊（0.9 对 4.6 天）和仅 IP 入院（0.7 对 3.1 天）的住院天数更少。他们还报告说，过去一年的 ED 就诊次数（44%对 62%）和 IP 入院次数（34%对 52%）较少。我们确定了门诊和非门诊 SCI 成人之间在个人特征、ED 就诊和 IP 入院方面的差异，从而更好地了解了 SCI 患者的特征。研究结果表明，在评估包括医院利用在内的长期健康结果时，需要根据门诊状态进行单独分析。
