The real predictors of disposition in patients with spinal cord injuries

Jeffrey A. Claridge, Martin Croce, Jordan A. Weinberg, Raquel M. Forsythe, Christopher Miller, Timothy C. Fabian, Laura Petrey, Kimberly A. Davis, Michael Moncure, Erik Streib, Brian Daley

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objectives: A primary goal of health care providers for managing patients with spinal cord injury (SCI) is to discharge them to a rehabilitation facility (RF) to allow for maximal functional recovery. This study was undertaken to analyze hospital mortality and disposition of patients with SCI with a specific focus on evaluating the effect of payor source on discharge to a RF. Our hypothesis was that commercial insurance (CI) would be the greatest influence of hospital disposition. Methods: All patients under 60 years of age with SCI over a 7-year period were identified from the trauma registry; and grouped according to payor source: No insurance (NI), Government insurance (GI), No Commercial insurance (NCI) (NCI = NI + GI), and CI. Results: A total of 492 patients with SCI were identified with a mean age of 33, an ISS of 29, and a hospital mortality of 7.7%. Independent predictors of mortality were cervical SCI and blood transfusions. Patients who were discharged to a RF had higher ISS and %CI with lower functional independent measurement scores compared with patients who were not discharged to a RF. Logistic regression analysis demonstrated that the predictors of disposition to a RF were CI (p < 0.001) and ISS (p = 0.002). Conclusion: The presence of CI was an independent predictor of disposition to a RF for patients with SCI. Lack of commercial insurance clearly compromises recovery and rehabilitation of patients with SCI and predicts outcome more clearly than any other parameter. Additional funding for patients without CI is necessary to afford all with an equal opportunity for maximal functional recovery.

Original languageEnglish (US)
Pages (from-to)178-186
Number of pages9
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume60
Issue number1
DOIs
StatePublished - Jan 1 2006

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Insurance
Spinal Cord Injuries
Rehabilitation
Hospital Mortality
Fetal Blood
Blood Transfusion
Health Personnel
Registries
Primary Health Care
Logistic Models
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

The real predictors of disposition in patients with spinal cord injuries. / Claridge, Jeffrey A.; Croce, Martin; Weinberg, Jordan A.; Forsythe, Raquel M.; Miller, Christopher; Fabian, Timothy C.; Petrey, Laura; Davis, Kimberly A.; Moncure, Michael; Streib, Erik; Daley, Brian.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 60, No. 1, 01.01.2006, p. 178-186.

Research output: Contribution to journalArticle

Claridge, JA, Croce, M, Weinberg, JA, Forsythe, RM, Miller, C, Fabian, TC, Petrey, L, Davis, KA, Moncure, M, Streib, E & Daley, B 2006, 'The real predictors of disposition in patients with spinal cord injuries', Journal of Trauma - Injury, Infection and Critical Care, vol. 60, no. 1, pp. 178-186. https://doi.org/10.1097/01.ta.0000198804.74514.0c
Claridge, Jeffrey A. ; Croce, Martin ; Weinberg, Jordan A. ; Forsythe, Raquel M. ; Miller, Christopher ; Fabian, Timothy C. ; Petrey, Laura ; Davis, Kimberly A. ; Moncure, Michael ; Streib, Erik ; Daley, Brian. / The real predictors of disposition in patients with spinal cord injuries. In: Journal of Trauma - Injury, Infection and Critical Care. 2006 ; Vol. 60, No. 1. pp. 178-186.
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