Abstract
Design:
Descriptive study.
Objectives:
To document the characteristics of rehospitalization following work-related tetraplegia, investigate risk factors for rehospitalization and identify opportunities for rehospitalization prevention.
Setting:
Workers' compensation administrative database with national coverage.
Methods:
The administrative database of a large workers' compensation provider was searched for work-related tetraplegia claims with dates of injury between 1 January 1989 and 31 December 1999. In all, 61 cases were identified where detailed rehospitalization information was available. Medical payment data were extracted, rehospitalization reasons were coded, and rates, costs and length of stay were calculated.
Results:
In all, 62% of cases were rehospitalized at some time during the period for which data were available. The average number of days the study group spent rehospitalized per year was 9.2 and the average annual cost was $14 197. The most common reasons for rehospitalization were dermatological (23%), orthopedic (18%) and urological (14%). It was found that as many as 74% of the total number of days persons spent rehospitalized, 64% of the monies spent on rehospitalization, and 47% of rehospitalizations could have been prevented.
Conclusions:
Consistent with earlier research, the ability to identify risk factors for rehospitalization was limited. However, the current study does highlight the extent to which rehospitalizations disrupt the lives of people with work-related tetraplegia and that a substantial proportion of rehospitalizations can be avoided.
Sponsorship:
The research was supported, in part, by a grant from the National Institute on Disability and Rehabilitation Research National Model SCI Systems (Grant no. H133N00024).
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Krause J . Secondary conditions and spinal cord injury: a model for prediction and prevention. Topics Spinal Cord Injury Rehabil 1996; 2: 58–70.
Meyers A et al. Rehospitalization and spinal cord injury: cross-sectional survey of adults living independently. Arch Phys Med Rehabil 1985; 66: 704–708.
Savic G, Short D, Weitzencamp D, Charlifue S, Gardner B . Hospital readmissions in people with chronic spinal cord injury. Spinal Cord 2000; 38: 371–377.
Pershouse K, Cox R, Dorsett P . Hospital readmissions in the first two years after initial rehabilitation for acute spinal cord injury. Topics Spinal Cord Injury Rehabil 2000; 6: 23–33.
Davidoff G et al. Rehospitalization after initial rehabilitation for acute spinal cord injury: incidence and risk factors. Arch Phys Med Rehabil 1990; 71: 121–124.
Vaidyanathan S et al. A review of the readmissions of patients with tetraplegia to the Regional Spinal Injuries Centre, Southport, United Kingdom, between January 1994 and December 1995. Spinal Cord 1998; 36: 838–846.
Webster B, Giunti G, Young A, Pransky G, Nesathurai S . Work-related tetraplegia: causes of injury and annual medical costs. Spinal Cord 2004; 42: 240–247.
Young A, Webster B, Giuntu G, Pransky G, Nesathurai S . Medical services provided following compensable work-related tetraplegia. Spinal Cord 2004; 42: 248–260.
US Department of Labor. Consumer Price Index – All Urban Consumers, US City Average, Medical Care, Series Id: CUUR0000SAM. Bureau of Labor Statistics. Available from URL: http://www.data.bls.gov/PDQ/servlet/SurveyOutputServlet?data_tool=latest_numbers&series_id=CUUR0000SAM&output_view=pct_1mth.
Harvey C, Wilson SE, Greene CG, Berkowitz M, Stripling TE . New estimates of the direct costs of traumatic spinal cord injuries: results of a nationwide survey. Paraplegia 1992; 30: 834–850.
DeVivo M, Richards J, Stover SL, Go B . Rehabilitation medicine: adding life to years. West J Med 1991; 154: 602–606.
Johnson R, Gerhart K, McCray J, Menconi J, Whiteneck G . Secondary conditions and spinal cord injury in a population-based sample. Spinal Cord 1998; 36: 45–50.
Ivie C, DeVivo M . Predicting unplanned hospitalizations in persons with spinal cord injury. Arch Phys Med Rehabil 1994; 75: 1182–1188.
Young J, Northup N . Re-hospitalization in years two and three following spinal cord injury. SCI Digest 1980; 1: 19–26.
DeVivo M, Whiteneck G, Charles E . The economic impact of spinal cord injury. In: Stover SL, Delisa JA, Whiteneck GG (eds). Spinal Cord Injury: Clinical Outcomes from the Model Systems. Aspen Publishers: Gaithersburg, Maryland 1995, pp. 234–271.
Cull J, Smith O . A preliminary note on demographic and personality correlates of decubitus ulcer incidence. J Psych 1973; 85: 225–227.
Lamid S, El Ghatit AZ . Smoking, spasticity and pressure sores in spinal cord injured patients. Am J Phys Med 1983; 62: 300–306.
Anderson TP, Andberg MM . Psychosocial factors associated with pressure sores. Arch Phys Med Rehabil 1979; 60: 341–346.
Meyers AR, Branch LG, Cupples LA, Lederman RI, Feltin M, Master RJ . Predictors of medical care utilization by independently living adults with spinal cord injuries. Arch Phys Med Rehabil 1989; 70: 471–476.
Anson C, Shepherd C . Incidence of secondary complications in spinal cord injury. Int J Rehabil Res 1996; 19: 55–66.
Middleton JW, Lim K, Taylor L, Soden R, Rutkowski S . Patterns of morbidity and rehospitalisation following spinal cord injury. Spinal Cord 2004; 42: 359–367.
Exner G, Meinecke FW . Trends in the treatment of patients with spinal cord lesions seen within a period of 20 years in German centers. Spinal Cord 1997; 35: 415–419.
Johnson RL, Brooks CA, Whiteneck GG . Cost of traumatic spinal cord injury in a population-based registry. Spinal Cord 1996; 34: 470–480.
Richards J . Pressure sores in SCI: psychosocial correlates. SCI Digest 1981; 3: 11–17.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Young, A., Webster, B., Giunti, G. et al. Rehospitalization following compensable work-related tetraplegia. Spinal Cord 44, 374–382 (2006). https://doi.org/10.1038/sj.sc.3101858
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.sc.3101858
