Medical, dental, and optical care utilization among community-living people with spinal cord injury in the United States

Abstract

Context/Objective

Information about patterns of healthcare utilization for people living with spinal cord injury (SCI) is currently limited, and this is needed to understand independent community living after SCI. This study investigates self-reported healthcare utilization among community-living people with SCI and assesses disparities across demographic, socioeconomic, and injury-related subgroups.

Design

Secondary analysis of cross-sectional survey data administered via telephone interview.

Setting

6 SCI Model Systems centers in the United States (California, Colorado, New Jersey, New York, Ohio, and Pennsylvania).

Participants

Adults with chronic, traumatic SCI who were community-living for at least one year after the completion of an inpatient rehabilitation program (N = 617).

Interventions

Not applicable.

Outcome Measures

Utilization of a usual source of 4 types of health care in the past 12 months: primary, SCI, dental, and optical.

Results

84% of participants reported utilizing primary care in the past year. More than half reported utilizing SCI (54%) and dental (57%) care, and 36% reported utilizing optical care. There were no significant differences across key subgroups in the utilization of primary care. Participants who had been injured for 5 years or less and participants with greater educational attainment were more likely to report utilizing SCI care. Participants with higher household income levels were more likely to report using dental care. Female participants and older age groups were more likely to report using optical care.

Conclusion

Rates of healthcare utilization among people with SCI are below recommended rates and vary across demographic, socioeconomic, and injury-related subgroups. This information can inform future research to target barriers to using healthcare services among community-living people with SCI.

Keywords:

• Spinal cord injuries
• Healthcare utilization
• Dental care
• Optical care
• Community living

Acknowledgements

The preliminary results from this analysis were presented at the annual meeting of the American Public Health Association, October 22, 2021. We would like to thank Ms. Rachel Byrne, Ms. Larissa Rosenberg, and Ms. Brittany Maronna for their assistance with data collection at Kessler Foundation. We would also like to acknowledge our collaborators at Craig Hospital, Rancho Los Amigos Rehabilitation Center, Icahn School of Medicine at Mount Sinai, University of Pittsburgh, and MetroHealth for assistance with data collection.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Contributors

All authors contributed significantly to the study design, data analysis, and/or writing of this manuscript. LM designed the objectives for the present analysis, conducted all data analysis, interpreted the results, and wrote the manuscript. AB designed and implemented the original study, interpreted the results of the present analysis, and wrote the manuscript. TB, JC, MS, MJR, and LW assisted with the design and implementation of the original study, assisted with the interpretation of the results of the present analysis, and provided feedback on the final manuscript.

Additional information

Funding

This work was supported by the Craig H. Neilsen Foundation under the Psychosocial Research (PSR) Postdoctoral Fellowship [#639798]; and the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) under the Northern New Jersey Spinal Cord Injury System [#90SI5026-01-00]. NIDILRR is a center within the Administration for Community Living (ACL), United States Department of Health and Human Services. The contents of this manuscript do not necessarily represent the policy of NIDILRR, ACL, or HHS, and you should not assume endorsement by the federal government.