Nizeyimana Eugene, Rhoda Anthea, Mothabeng Joyce, Theron Francois, Joseph Conran
Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa.
Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa.
S Afr J Physiother. 2025 Jun 6;81(1):2133. doi: 10.4102/sajp.v81i1.2133. eCollection 2025.
Spinal cord injury (SCI) significantly impacts quality of life (QoL) through physical disabilities and reduced social participation.
This study compared health system indicators, social factors and self-reported QoL between individuals with SCI accessing public versus private healthcare in South Africa.
A cross-sectional survey using the International Spinal Cord Injury (InSCI) community survey questionnaire was conducted with 200 SCI individuals (156 public, 44 private sector) from Cape Town and Pretoria. Chi-square tests and correlation analyses were performed.
Significant disparities were observed between cohorts. Public sector participants reported higher rates of disability pension receipt (82.1% vs 54.5%) and greater challenges accessing various services. Overall, self-reported QoL was 56%, with the private cohort reporting significantly higher satisfaction (64% vs 52%). Private sector participants also reported higher satisfaction with living conditions and personal relationships. Access to disability pension and healthcare negatively correlated with QoL, while access to public spaces, medication, transport and nursing care positively correlated with QoL.
This study reveals significant disparities in health system performance, social factors and QoL between SCI individuals accessing public versus private healthcare in South Africa.
Findings highlight the need to address systemic inequities in healthcare access and social support for individuals with SCI to improve QoL across sectors.
脊髓损伤（SCI）通过身体残疾和社会参与度降低对生活质量（QoL）产生重大影响。
本研究比较了南非使用公共医疗与私人医疗的脊髓损伤患者在卫生系统指标、社会因素和自我报告的生活质量方面的差异。
采用国际脊髓损伤（InSCI）社区调查问卷对来自开普敦和比勒陀利亚的200名脊髓损伤患者（156名公共医疗患者，44名私立医疗患者）进行了横断面调查。进行了卡方检验和相关性分析。
两组之间观察到显著差异。公共医疗参与者领取残疾抚恤金的比例更高（82.1%对54.5%），在获得各种服务方面面临更大挑战。总体而言，自我报告的生活质量为56%，私立医疗组的满意度显著更高（64%对52%）。私立医疗参与者对生活条件和人际关系也报告了更高的满意度。获得残疾抚恤金和医疗服务与生活质量呈负相关，而获得公共场所、药物、交通和护理服务与生活质量呈正相关。
本研究揭示了南非使用公共医疗与私人医疗的脊髓损伤患者在卫生系统绩效、社会因素和生活质量方面的显著差异。
研究结果强调需要解决医疗服务获取和社会支持方面的系统性不平等问题，以改善各部门脊髓损伤患者的生活质量。
