Department of Rehabilitation Medicine, Second Affiliated Hospital of Kunming Medical University, Kunming, China.
Department of Rehabilitation Medicine, Kunming Medical University, Kunming, China.
Ann Med. 2024 Dec;56(1):2333890. doi: 10.1080/07853890.2024.2333890. Epub 2024 Apr 1.
Medical security support for rehabilitation therapy in China is different from that in other countries. We investigated whether the discharge plan to continue rehabilitation therapy in tertiary hospitals for patients after traumatic spinal cord injury (TSCI) was influenced by payment sources or other conditions. This was a cross-sectional, observational study. Information was collected on the general condition, caregiver, types of payment sources for continued rehabilitation, American Spinal Injury Association Impairment Scale (AIS) scores, and discharge plans. In total, 135 patients with TSCI (107 male, mean age 41.00 ± 13.73 years, mean spinal cord injury duration 238.43 ± 345.54 days) were enrolled. Medical insurance (43%) and out-of-pocket payments (27.4%) were the primary payment sources. Although most patients were beyond the acute phase, 40% continued rehabilitation therapy at other tertiary hospitals. The caregiver, payment sources, injury level, AIS level, and complete urinary tract infection (UTI) were different due to discharge plans ( > .05). Patients seemingly consider a higher AIS level and co-UTI as the requirement for tertiary hospital therapy. In non-medical insurance payment source patients, the discharge plan also differed due to the AIS level and co-UTI ( > .05). However, in medical insurance patients, the discharge plan differed only in terms of TSCI duration ( > .05). The restricted duration of medical coverage restricted the continuation of rehabilitation therapy and influenced the discharge plan of most patients with TSCI.
中国康复治疗的医疗保障与其他国家不同。我们调查了外伤性脊髓损伤(TSCI)患者在三级医院出院后继续康复治疗的计划是否受支付来源或其他条件的影响。这是一项横断面、观察性研究。收集了一般情况、照顾者、继续康复治疗的支付来源类型、美国脊髓损伤协会损伤分级(AIS)评分和出院计划。共纳入 135 例 TSCI 患者(男 107 例,平均年龄 41.00±13.73 岁,平均脊髓损伤病程 238.43±345.54 天)。医疗保险(43%)和自费(27.4%)是主要支付来源。尽管大多数患者已过急性期,但仍有 40%的患者在其他三级医院继续康复治疗。照顾者、支付来源、损伤水平、AIS 水平和完全性尿路感染(UTI)因出院计划不同而不同(>.05)。患者似乎认为 AIS 水平较高和合并 UTI 是在三级医院治疗的要求。在非医疗保险支付来源的患者中,AIS 水平和合并 UTI 也会影响出院计划(>.05)。然而,在医疗保险患者中,仅 TSCI 病程会影响出院计划(>.05)。医疗保险覆盖期限的限制限制了康复治疗的延续,并影响了大多数 TSCI 患者的出院计划。