Abstract
Study design
Retrospective analysis of self-report and administrative billing data.
Objectives
(1) Identify the self-reported prevalence of seven chronic health conditions (CHCs) in adults with chronic, traumatic spinal cord injury (SCI), (2) Examine the relationships between the presence of CHC with future hospital admissions and total number of inpatient days and (3) identify predictors of utilization.
Setting
Data were collected from participants living in and utilizing hospitals in South Carolina, USA.
Methods
Participants were identified through the South Carolina SCI Surveillance System Registry. Between 2010 and 2013, 963 adults ( > 18 years old) with chronic ( > 1-year), traumatic SCI completed self-report assessments (SRAs); this analysis includes data from 787 individuals. The presence/absence of the seven CHC was assessed using self-report data. Administrative billing data were used to assess hospital utilization in non-federal, South Carolina hospitals in the year following the SRA.
Results
In all, 40.5% reported no CHC; 23.4% reported one CHC and 36.1% reported having two or more CHC. The most commonly reported CHCs were hypertension (43.1%), high cholesterol (32.2%) and diabetes (15.8%). In total, 59% had at least one hospital admission in the year following the SRA (mean 3 ± 5; range 0–45; median = 1). The mean total inpatient days was 15.7 ± 43 days (range 0–365; median = 1). Predictors of hospital admission included CHC, pressure sores, education, prior hospitalization and injury severity. With the exception of CHC, each was also associated with total number of inpatient days.
Conclusions
CHC are prevalent and associated with hospital admissions in adults with chronic, traumatic SCI.
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Change history
31 October 2019
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Author contributions
NDD was responsible for leading the manuscript, drafting of the research questions and revising the manuscript. DM was responsible for analyzing and interpreting the data. He contributed to revising the manuscript. BC was responsible for analyzing and interpreting the data. She contributed to revising the manuscript. JSK is the senior investigator and Principal Investigator of the research program. He was responsible for designing and directing the project and served as a mentor to the lead author, as well as being responsible for revising the manuscript and approving the final version.
Funding
The contents of this publication were developed under grants from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant numbers 90IF0119 and 90RT5003), and the South Carolina Spinal Cord Injury Research Fund (SCSCIRF) grant # SCIRF 09-001. NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this publication do not necessarily represent the policy of NIDILRR, ACL, HHS, SCSCIRF and you should not assume endorsement by the Federal Government or the state of South Carolina.
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We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research.
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DiPiro, N.D., Murday, D., Corley, E.H. et al. Prevalence of chronic health conditions and hospital utilization in adults with spinal cord injury: an analysis of self-report and South Carolina administrative billing data. Spinal Cord 57, 33–40 (2019). https://doi.org/10.1038/s41393-018-0185-9
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DOI: https://doi.org/10.1038/s41393-018-0185-9
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