Satisfaction with access and quality of healthcare services for people with spinal cord injury living in the community

Abstract

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.

Results: Close to three-quarter of participants (70%) indicated satisfaction with healthcare services received for SCI related health conditions. Elderly individuals (61+ years old) rated the availability and quality of healthcare 6% to 11% higher than younger individuals. The perceived fulfillment of healthcare needs was lower in people with incomplete paraplegia (odds ratio (OR) 2.11, 95%-credibility interval (CI) 1.18–3.84), chronic pain (OR 1.85, CI 1.12–3.08), insufficient access to long distance transportation (OR 5.81, CI 2.74–12.82), and longer travel distances to specialized SCI centers.

Conclusion: Perceived inadequateness of access to healthcare services was partly related to transportation barriers, suggesting that outreach services or support with transportation are possible solutions. People with incomplete paralysis and pain consistently rated the fulfillment of care needs associated with SCI less favorably, pointing to the need for enhanced advocacy for this vulnerable groups.

Keywords:

• Spinal cord injury
• Healthcare availability
• Healthcare quality
• Patient satisfaction
• Spatial analysis

Acknowledgments

We are grateful to all the participants of the SwiSCI survey for their time and effort spent in responding to the questions. We thank Melissa Miller for editing of the manuscript. This study has been financed in the framework of the Swiss Spinal Cord Injury Cohort Study (SwiSCI, www.swisci.ch), supported by the Swiss Paraplegic Foundation.

The members of the SwiSCI Steering Committee are:

Xavier Jordan, Bertrand Léger (Clinique Romande de Réadaptation, Sion); Michael Baumberger, Hans Peter Gmünder (Swiss Paraplegic Center, Nottwil); Armin Curt, Martin Schubert (University Clinic Balgrist, Zürich); Margret Hund-Georgiadis, Kerstin Hug (REHAB Basel, Basel); Thomas Troger (Swiss Paraplegic Association, Nottwil); Daniel Joggi (Swiss Paraplegic Foundation, Nottwil); Hardy Landolt (Representative of persons with SCI, Glarus); Nadja Münzel (Parahelp, Nottwil); Mirjam Brach, Gerold Stucki (Swiss Paraplegic Research, Nottwil); Martin Brinkhof (SwiSCI Study Center at Swiss Paraplegic Research, Nottwil).

Disclaimer statements

Contributors None.

Funding None.

Disclosure of interest All authors were salaried by organizations financially compensated by the Swiss Paraplegic Foundation.

Conflicts of interest None.

Ethics approval None.

ORCID

Elias Ronca http://orcid.org/0000-0001-9345-9002

Anke Scheel-Sailer http://orcid.org/0000-0003-3820-6664

Hans Georg Koch http://orcid.org/0000-0003-3790-7039

Stefan Essig http://orcid.org/0000-0003-3228-7010

Armin Gemperli http://orcid.org/0000-0002-2363-0625

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.