Utilization, access and satisfaction with primary care among people with spinal cord injuries: a comparison of three countries.


STUDY DESIGN:Cross-sectional; survey. OBJECTIVES:To describe the utilization, accessibility and satisfaction of primary and preventive health-care services to individuals with long-term spinal cord injuries, and compare results among three countries: the United States, Canada and the United Kingdom. SETTING:The Canadian sample was obtained from the Canadian Paraplegic Association-Ontario and Manitoba Divisions. The British sample was recruited from the Northwest Regional Spinal Injuries Centre in Southport and National Spinal Injuries Centre at Stoke Mandeville Hospital in Aylesbury. The American sample was recruited through Craig Hospital in Englewood, CO, USA. METHOD:A total sample of 373 individuals aging with a spinal cord injury participated in a mailed survey. The Health Care Questionnaire was used to measure utilization, access and satisfaction with primary care and preventive services. RESULTS:In total, 93% of individuals reported having a family doctor, 63% had a spinal injuries specialist and 56% had both a family doctor and spinal injuries specialist. Considerable duplication of services occurred for general medical and preventive services, although lifestyle and emotional issues were not addressed for over 75% of the participants. Significant differences were found in utilization among Canada, US and UK, with Canadians most likely to receive health care from family physicians and Americans most likely to receive care from specialists. Access to and satisfaction with health services was not significantly different among countries. CONCLUSION:People with long-standing spinal cord injuries develop complex maps by which they seek out appropriate primary health-care and preventive services. Given the differences among countries, it is clear that the health delivery model plays an important role in how and where individuals receive health services.


Spinal Cord


Spinal cord


Donnelly C,McColl MA,Charlifue S,Glass C,O'Brien P,Savic G,Smith K




Has Abstract


2007-01-01 00:00:00














  • Successful tracheostomy decannulation after complete or sensory incomplete cervical spinal cord injury.

    abstract:STUDY DESIGN:Retrospective study. OBJECTIVES:To report the successful tracheostomy decannulation/extubation in cervical spinal cord injury (C-SCI) patients. SETTING:Tertiary university hospital, pulmonary rehabilitation center. METHODS:Complete or sensory incomplete C-SCI patients who had received invasive acute pha...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Kim DH,Kang SW,Choi WA,Oh HJ

    更新日期:2017-06-01 00:00:00

  • Microglia inhibition is a target of mild hypothermic treatment after the spinal cord injury.

    abstract:STUDY DESIGN:A basic study using a spinal cord injury (SCI) model in rats. OBJECTIVES:The effect of mild hypothermic treatment on histological changes and motor function after a rat spinal cord compression injury was assessed. METHODS:Mild spinal cord compression was performed at the eleventh thoracic vertebral level...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Morino T,Ogata T,Takeba J,Yamamoto H

    更新日期:2008-06-01 00:00:00

  • Neurogenic heterotopic ossification of the hands in a patient with spinal cord injury: a case report.

    abstract:STUDY DESIGN:The study was designed as a case report. OBJECTIVE:The objective of this study was to report an unusual case of bilateral neurogenic heterotopic ossification of the hands in a patient with spinal cord injury. SETTING:Physical Medicine and Rehabilitation department in Sale, Morocco. METHODS:A 47-year-old...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Bendeddouche I,Aissaoui N,Hajjaj-Hassouni N

    更新日期:2011-10-01 00:00:00

  • Use of a free jejunal graft for oesophageal reconstruction following perforation after cervical spine surgery: case report and review of the literature.

    abstract:STUDY DESIGN:: Single-subject (male, 16 years of age) case. OBJECTIVES:To demonstrate a suitable method for oesophageal repair after perforation as a complication of anterior spinal fusion in an individual with quadriplegia, and to review the literature on oesophageal perforation and repair. SETTING:University hospit...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Küntscher MV,Erdmann D,Boltze WH,Germann G

    更新日期:2003-10-01 00:00:00

  • Acute respiratory distress syndrome and acute lung injury in patients with vertebral column fracture(s) and spinal cord injury: a nationwide inpatient sample study.

    abstract:STUDY DESIGN:Retrospective Nationwide Inpatient Sample (NIS) study. OBJECTIVES:To determine national trends in prevalence, risk factors and mortality for vertebral column fracture (VCF) and spinal cord injury (SCI) patients with and without acute respiratory distress syndrome/acute lung injury (ARDS/ALI). SETTING:Uni...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Veeravagu A,Jiang B,Rincon F,Maltenfort M,Jallo J,Ratliff JK

    更新日期:2013-06-01 00:00:00

  • High dose methylprednisolone in the management of acute spinal cord injury - a systematic review from a clinical perspective.

    abstract:STUDY DESIGN:Systematic literature review for primary data using predefined inclusion, exclusion and validity criteria. Primary outcome measure was standardised neurological examination or neurological function. Secondary outcomes; acute mortality, early morbidity. OBJECTIVES:To access the literature available to clin...

    journal_title:Spinal cord

    pub_type: 杂志文章,评审


    authors: Short DJ,El Masry WS,Jones PW

    更新日期:2000-05-01 00:00:00

  • Clinical associations with telomere length in chronic spinal cord injury.

    abstract:STUDY DESIGN:Cross-sectional study OBJECTIVES: To determine clinical factors associated with telomere length in persons with chronic spinal cord injury (SCI). SETTING:Veterans Affairs Medical Center, Boston, MA. METHODS:Two hundred seventy-eight participants with chronic SCI provided blood samples for measurement of ...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Monroe DM,Goldstein RL,Teylan MA,Hart JE,DeVivo I,Orr EH,Garshick E

    更新日期:2019-12-01 00:00:00

  • Fat oxidation at different intensities in wheelchair racing.

    abstract:STUDY DESIGN:Determination of fat oxidation at three different intensities in trained wheelchair athletes on the treadmill. OBJECTIVE:The aim of the study was to assess the level and highest rate of fat oxidation in endurance-trained wheelchair athletes for recommendation on endurance training. SETTING:Institute of S...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Knechtle B,Müller G,Willmann F,Eser P,Knecht H

    更新日期:2004-01-01 00:00:00

  • Acute transverse myelitis in a 7-month-old boy after diphtheria-tetanus-pertussis immunization.

    abstract:STUDY DESIGN:Case report of a 7-month-old boy, who developed acute transverse myelitis after diphtheria-tetanus-pertussis immunization. OBJECTIVES:To describe the clinical course of acute transverse myelitis in an infant and to review the literature regarding the association of acute transverse myelitis and vaccinatio...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Riel-Romero RM

    更新日期:2006-11-01 00:00:00

  • Psychological impact of the management of methicillin-resistant Staphylococcus aureus (MRSA) in patients with spinal cord injury.

    abstract:BACKGROUND:Management of MRSA infection includes immediate isolation of the patient. Long periods of isolation are considered to be psychologically detrimental, though little information is available about the impact of isolation as an infection control procedure. The purpose of this study is to examine the psychologic...

    journal_title:Spinal cord

    pub_type: 临床试验,杂志文章


    authors: Kennedy P,Hamilton LR

    更新日期:1997-09-01 00:00:00

  • Static respiratory pressures in patients with post-traumatic tetraplegia.

    abstract::The purpose of this study was to examine ventilatory muscle strength as represented by static respiratory pressures in 30 tetraplegic patients with a complete lesion between the fifth and the eighth cervical vertebrae. The Inspiratory/Expiratory Pressure Meter was used to obtain maximum static expiratory mouth pressur...

    journal_title:Spinal cord

    pub_type: 临床试验,杂志文章


    authors: Gounden P

    更新日期:1997-01-01 00:00:00

  • Incidence, prevalence and epidemiology of spinal cord injury: what learns a worldwide literature survey?

    abstract:STUDY DESIGN:Literature survey. OBJECTIVES:To provide an overview of the literature data on incidence, prevalence and epidemiology of spinal cord injury (SCI) worldwide and to study their evolution since 1977. SETTING:University Antwerp. METHODS:The literature from 1995 onwards was searched on Pubmed. To include evo...

    journal_title:Spinal cord

    pub_type: 杂志文章,meta分析,评审


    authors: Wyndaele M,Wyndaele JJ

    更新日期:2006-09-01 00:00:00

  • The short-term effect of hippotherapy on spasticity in patients with spinal cord injury.

    abstract:STUDY DESIGN:Assessment of spasticity before and after hippotherapy treatment. OBJECTIVE:To evaluate the short-term effect of hippotherapy on spasticity of spinal cord injured patients (SCIs). SETTING:Swiss Paraplegic Centre, Nottwil. METHODS:32 patients with spinal cord injury with various degrees of spasticity had...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Lechner HE,Feldhaus S,Gudmundsen L,Hegemann D,Michel D,Zäch GA,Knecht H

    更新日期:2003-09-01 00:00:00

  • Pediatric spinal cord injury in Sweden; how to identify a cohort of rare events.

    abstract:STUDY DESIGN:Register study enhanced and verified by medical records and personal interviews and examinations. SETTINGS:Sweden. OBJECTIVES:To define a method of identifying a study population of rare events. To point out the relative importance of every step, an example is given of identifying persons who sustained t...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Augutis M,Malker H,Levi R

    更新日期:2003-06-01 00:00:00

  • Contribution of D-Dimer determination in the exclusion of deep venous thrombosis in spinal cord injury patients.

    abstract:UNLABELLED:Deep vein thrombosis (DVT) is a common complication of paraplegia despite prophylactic anticoagulant therapy. The diagnosis relies primarily on ultrasonography or phlebography; these investigations are difficult, expensive and can be time-consuming in paraplegic patients. STUDY DESIGN:To evaluate the useful...

    journal_title:Spinal cord

    pub_type: 临床试验,杂志文章


    authors: Roussi J,Bentolila S,Boudaoud L,Casadevall N,Vallée C,Carlier R,Lortat-Jacob S,Dizien O,Bussel B

    更新日期:1999-08-01 00:00:00

  • Review of the efficacy and safety of transanal irrigation for neurogenic bowel dysfunction.

    abstract:STUDY DESIGN:Neurogenic bowel dysfunction (NBD) is a common occurrence after spinal cord injury (SCI) and in patients with spina bifida or multiple sclerosis. The impact of NBD on well-being is considerable, affecting both physical and psychological aspects of quality of life. Transanal irrigation (TAI) of the colon pr...

    journal_title:Spinal cord

    pub_type: 杂志文章,评审


    authors: Emmanuel A

    更新日期:2010-09-01 00:00:00

  • A retrospective review of the ambulatory blood pressure patterns and diurnal urine production in subgroups of spinal cord injured patients.

    abstract:STUDY DESIGN:Retrospective study. OBJECTIVES:To quantify diurnal blood pressure (BP) patterns and nocturnal hypertension and to measure diurnal urine production in spinal cord injury (SCI) patients with clinically significant disorders of BP control. SETTING:A specialist state-based spinal cord service in Victoria, A...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Goh MY,Wong EC,Millard MS,Brown DJ,O'Callaghan CJ

    更新日期:2015-01-01 00:00:00

  • Lower urinary tract function in spinal cord-injured rats: midthoracic contusion versus transection.

    abstract:OBJECTIVES:To compare changes in lower urinary tract (LUT) function with modifications in pathways that regulate LUT function using two different animal models (incomplete and complete) of spinal cord injury (SCI). METHODS:Female Sprague-Dawley rats were used. SCI was made at Th8/9 by a contusion injury (contusion, n=...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Mitsui T,Murray M,Nonomura K

    更新日期:2014-09-01 00:00:00

  • Spinal intradural extramedullary cavernous angioma: case report and review of the literature.

    abstract:STUDY DESIGN:Case report and review of the literature. OBJECTIVE:To report an unusual case of a spinal intradural extramedullary cavernous angioma (CA), located at the cauda equina, and to compare it with the previously published 22 surgically treated cases in the literature. SETTING:Ankara, Turkey. METHOD:A 67-year...

    journal_title:Spinal cord

    pub_type: 杂志文章,评审


    authors: Er U,Yigitkanli K,Simsek S,Adabag A,Bavbek M

    更新日期:2007-09-01 00:00:00

  • Microvascular changes in the lower extremities of paraplegics with heterotopic ossification.

    abstract:OBJECTIVES:To investigate the morphological aspects of blood microvasculature of the skin and subcutaneous tissues in subjects with paraplegia with heterotopic ossification (HO). METHODS:In two patients with traumatic spinal cord injury and HO, punch biopsies of skin and hypodermic soft tissue in the region of HO near...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Lotta S,Scelsi L,Scelsi R

    更新日期:2001-11-01 00:00:00

  • Traumatic central cord syndrome: neurological and functional outcome at 3 years.

    abstract:STUDY DESIGN:Retrospective cohort analysis with prospective follow-up. OBJECTIVES:To evaluate neurological and functional recovery following central cord syndrome. SETTING:Northern Ireland, population 1.8 million. METHODS:Twenty-seven cords were identified in 1 year. Five managed conservatively and 22 with surgery. ...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Stevenson CM,Dargan DP,Warnock J,Sloan S,Espey R,Maguire S,Eames N

    更新日期:2016-11-01 00:00:00

  • Spinal extradural cysticercosis: a case report.

    abstract::An extremely rare case of extradural spinal cysticercosis in an adult male is presented. The patient had evidence of extradural granulation tissue with associated destruction of C4 and C5 pedicles and laminae, causing tetraparesis. Histopathological examination revealed evidence of a degenerated cysticercal cyst with ...

    journal_title:Spinal cord

    pub_type: 杂志文章,评审


    authors: Mohanty A,Das S,Kolluri VR,Das BS

    更新日期:1998-04-01 00:00:00

  • Developing a national registry of veterans with spinal cord dysfunction: experiences and implications.

    abstract::We describe the development of a registry of veterans with spinal cord dysfunction who have been treated within the Department of Veterans Affairs health care facilities. The registry departs from the function and structure of traditional registries by a more extensive utilization of advances in computer technology; i...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Samsa G,Hoenig H,Carswell J,Sloane R,Bovender CR,VanDeusen Lukas C,Horner RD

    更新日期:1998-01-01 00:00:00

  • Profile of spinal injuries in Lagos, Nigeria.

    abstract:STUDY DESIGN:Retrospective study. OBJECTIVE:To describe the pattern and outcome of spinal cord injuries in Lagos, Nigeria. SETTING:Nigeria, Lagos. METHODS:This retrospective review of cases was conducted at Lagos University Teaching Hospital (LUTH), Lagos, between January 1992 and December 2006. RESULTS:A total of ...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Obalum DC,Giwa SO,Adekoya-Cole TO,Enweluzo GO

    更新日期:2009-02-01 00:00:00

  • The efficacy of biochemical markers in patients with ossification of posterior longitudinal ligament of the spine.

    abstract:STUDY DESIGN:Serum levels of carboxyterminal propeptide of type I collagen (PICP), osteocalcin (OC), carboxyterminal telopeptide of type I collagen (ICTP) and urinary levels of pyridinoline (Pyr) and deoxypyridinoline (Dpyr) were measured in patients with ossification of posterior longitudinal ligament of the spine (OP...

    journal_title:Spinal cord

    pub_type: 临床试验,杂志文章


    authors: Ishihara C,Kushida K,Takahashi M,Ohishi T,Murata H,Nagano A,Goto S

    更新日期:2000-04-01 00:00:00

  • Quantitative assessment of spinal cord perfusion by using contrast-enhanced ultrasound in a porcine model with acute spinal cord contusion.

    abstract:OBJECTIVES:To quantify spinal cord perfusion by using contrast-enhanced ultrasound (CEUS) in a porcine model with acute spinal cord injury. METHODS:Microcirculatory changes of acute spinal cord injury were shown by CEUS in a porcine model with spinal cord contusion at three selected time points, coupling with conventi...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Huang L,Lin X,Tang Y,Yang R,Li AH,Ye JC,Chen K,Wang P,Shen HY

    更新日期:2013-03-01 00:00:00

  • Guillian-Barré syndrome in high tetraplegia following acute respiratory illness.

    abstract:STUDY DESIGN:A case report of a Guillain-Barré syndrome (GBS) variant presenting in a patient with a high cervical spinal cord injury (SCI). OBJECTIVES:To illustrate a clinical presentation of GBS in an individual with chronic SCI. SETTING:Vancouver General Hospital, Vancouver, BC, Canada. METHODS/RESULTS:A 31-year-...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Grant C,Briscoe N,Mezei M,Krassioukov A

    更新日期:2011-03-01 00:00:00

  • Comparative analysis of goal achievement during rehabilitation for older and younger adults with spinal cord injury.

    abstract:OBJECTIVE:To evaluate rehabilitation outcome in a representative sample of older and younger SCI patients. DESIGN:Case series, consecutive sample, survey. SETTING:Tertiary care, spinal cord injury unit (National Spinal Injuries Centre), Stoke Mandeville Hospital. PARTICIPANTS:One hundred and forty-seven male and 45 ...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Kennedy P,Evans MJ,Berry C,Mullin J

    更新日期:2003-01-01 00:00:00

  • Suprascapular nerve entrapment in a patient with a spinal cord injury.

    abstract:STUDY DESIGN:Case report. OBJECTIVES:To describe a case of suprascapular nerve entrapment (SNE) in a patient with a spinal cord injury (SCI) as a cause of shoulder pain. SETTING:Physical Medicine and Rehabilitation Institute, Nancy, France. REPORT:Six months after the occurrence of acute paraplegia T9 ASIA, a 45-yea...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Facione J,Beis JM,Kpadonou GT,Lagauche D,Touillet A,Braun M,Le Chapelain L,Paysant J

    更新日期:2011-06-01 00:00:00

  • Sequential treatment of chronic constipation in paraplegic subjects.

    abstract::Chronic constipation is the main gastrointestinal complaint of spinal cord injury (SCI) patients, and has a significant effect on patients' lives, concerning nursing dependence, morbidity and complications. Many therapies have been proposed to treat chronic severe constipation, most of them with limited effect or bein...

    journal_title:Spinal cord

    pub_type: 临床试验,杂志文章


    authors: Badiali D,Bracci F,Castellano V,Corazziari E,Fuoco U,Habib FI,Scivoletto G

    更新日期:1997-02-01 00:00:00