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














  • 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

  • Management of bowel dysfunction in the community after spinal cord injury: a postal survey in the Republic of Korea.

    abstract:STUDY DESIGN:A cross-sectional postal survey. OBJECTIVES:To describe defecation stimulation methods and their outcomes, and to investigate the impact of bowel dysfunction on the quality of life (QoL) in community-dwelling persons with spinal cord injury in South Korea. SETTING:Community-based, Korea. METHODS:A cross...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Kim JY,Koh ES,Leigh J,Shin HI

    更新日期:2012-04-01 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

  • 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

  • Extra pontine myelinolysis in a tetraplegic patient: case report.

    abstract::Hyposmolar hyponatremia (serum sodium < 130 mmol/l) is a common phenomenon in the spinal cord injury (SCI) patient population and in most cases, it is of relatively little consequence. However, rapid correction or over correction of hyponatremia (a change in serum sodium > 25 mmol/l within 48 h) has been linked to Cen...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Moore K,Midha M

    更新日期:1997-05-01 00:00:00

  • Mediating effects of social support and self-concept on depressive symptoms in adults with spinal cord injury.

    abstract:STUDY DESIGN:Cross-sectional, correlational design. OBJECTIVES:To examine the effects of individual demographics, activities of daily living, social support, and self-concept on depressive symptoms in people with spinal cord injury (SCI). SETTING:A convenience sample of 135 adults with SCI was recruited from medical ...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Huang CY,Chen WK,Lu CY,Tsai CC,Lai HL,Lin HY,Guo SE,Wu LM,Chen CI

    更新日期:2015-05-01 00:00:00

  • Are adults with spinal cord injury meeting the spinal cord injury-specific physical activity guidelines? A look at a sample from a Canadian province.

    abstract:STUDY DESIGN:One cross-sectional study. OBJECTIVES:To examine the extent to which a sample of adults with spinal cord injury (SCI) meet the SCI-specific physical activity guidelines and to identify potential demographic, injury and motivational characteristics related to participation. SETTING:Quebec, Canada. METHOD...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Rocchi M,Routhier F,Latimer-Cheung AE,Ginis KAM,Noreau L,Sweet SN

    更新日期:2017-05-01 00:00:00

  • Sequential MR studies of cervical cord injury: correlation with neurological damage and clinical outcome.

    abstract:OBJECTIVE:To determine which images provide the most useful information and the best time to perform prognostic MRI. DESIGN:The severity of neurological complications was assessed using the ASIA impairment scale. MRI was first performed within 48 h of injury, and was subsequently performed after 2-3 weeks, 3 months, 6...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Shimada K,Tokioka T

    更新日期:1999-06-01 00:00:00

  • Epidural spinal cord stimulation for the control of spasticity in spinal cord injury patients lacks long-term efficacy and is not cost-effective.

    abstract::Epidural spinal cord stimulation has been used to decrease spasticity and spasms in spinal cord injury patients. However, the long-term benefits of this procedure have not been determined. We therefore conducted a retrospective study of the possible long-term efficacy of the epidural spinal cord stimulator for the rel...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Midha M,Schmitt JK

    更新日期:1998-03-01 00:00:00

  • Low cervical chordoma: case report.

    abstract::We report a case of a 32-year old woman with radicular symptoms associated with a low cervical chordoma. According to our knowledge this is the 10th case of low cervical chordoma reported in the literature. ...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Inci S,Palaoğlu S,Onol B,Erbengi A

    更新日期:1996-06-01 00:00:00

  • Feasibility of a novel diagnostic chart of intramedullary spinal cord tumors in magnetic resonance imaging.

    abstract:STUDY DESIGN:Retrospective chart review. OBJECTIVES:Each type of intramedullary spinal cord tumor (IMSCT) has specific anatomical and pathological features visible on magnetic resonance (MR) imaging. The purpose of this study was to investigate the accuracy of preoperative IMSCT diagnosis using our diagnostic chart of...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Arima H,Hasegawa T,Togawa D,Yamato Y,Kobayashi S,Yasuda T,Matsuyama Y

    更新日期:2014-10-01 00:00:00

  • A systematic review of risk factors for the development and recurrence of pressure ulcers in people with spinal cord injuries.

    abstract:STUDY DESIGN:A systematic review was undertaken, based upon methods recommended for effectiveness questions but adapted to identify observational risk factor (RF) studies. OBJECTIVES:The literature identifies many RFs for pressure ulcer (PU) recurrence and development; however, RFs independently predictive of PU devel...

    journal_title:Spinal cord

    pub_type: 杂志文章,meta分析,评审


    authors: Marin J,Nixon J,Gorecki C

    更新日期:2013-07-01 00:00:00

  • Patient experience survey in telemedicine for spinal cord injury patients.

    abstract:STUDY DESIGN:Patient feedback study. OBJECTIVES:To measure how patients value the telemedicine consultation service at the National Spinal Injuries Centre over a period of 8 months. SETTING:United Kingdom (south of England). METHODS:Telephone survey conducted by an external surveyor who does not work in the departme...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Yuen J,Thiyagarajan CA,Belci M

    更新日期:2015-04-01 00:00:00

  • Soluble complement receptor type 1 inhibits complement system activation and improves motor function in acute spinal cord injury.

    abstract:STUDY DESIGN:Spinal cord injured rat model, treated with soluble complement receptor type 1 (sCR1). SETTING:Experimental Animal Department of China Medical University, Shenyang, China. OBJECTIVES:Soluble CR1 is a powerful inhibitor of complement activation. In this study, we investigate the effectiveness of sCR1 on s...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Li LM,Li JB,Zhu Y,Fan GY

    更新日期:2010-02-01 00:00:00

  • Observational study of the effectiveness of spinal cord injury rehabilitation using the Spinal Cord Injury-Ability Realization Measurement Index.

    abstract:STUDY DESIGN:Retrospective observational study. OBJECTIVES:The objective of this study was to determine the rehabilitation potential and the extent to which it is realized in a cohort of spinal cord injury patients using the Spinal Cord Injury-Ability Realization Measurement Index (SCI-ARMI) and to study the clinical ...

    journal_title:Spinal cord

    pub_type: 杂志文章,多中心研究


    authors: Scivoletto G,Bonavita J,Torre M,Baroncini I,Tiberti S,Maietti E,Laurenza L,China S,Corallo V,Guerra F,Buscaroli L,Candeloro C,Brunelli E,Catz A,Molinari M

    更新日期:2016-06-01 00:00:00

  • How does knowledge about spinal cord injury-related complications develop in subjects with spinal cord injury? A descriptive analysis in 214 patients.

    abstract:STUDY DESIGN:Monocentric cohort study. OBJECTIVE:To investigate the acquisition of knowledge about spinal cord injury (SCI)-related complications in SCI patients. SETTING:Level 1 trauma center. METHODS:All patients with a traumatic or non-traumatic SCI were included in the study. Data were collected at admission, po...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Thietje R,Giese R,Pouw M,Kaphengst C,Hosman A,Kienast B,van de Meent H,Hirschfeld S

    更新日期:2011-01-01 00:00:00

  • Non-assisted treadmill training does not improve motor recovery and body composition in spinal cord-transected mice.

    abstract:STUDY DESIGN:Experiments in a mouse model of complete paraplegia. OBJECTIVES:To evaluate the effect of non-assisted treadmill training on motor recovery and body composition in completely spinal cord-transected mice. SETTINGS:Laval University Medical Center, Neuroscience Unit, Quebec City, Quebec, Canada. METHODS:Fo...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Ung RV,Lapointe NP,Rouleau P,Guertin PA

    更新日期:2010-10-01 00:00:00

  • Vesicoureteral reflux in the early stage of spinal cord injury: a retrospective study.

    abstract:STUDY DESIGN:A retrospective study. OBJECTIVES:To investigate the risk factors of vesicoureteral reflux in the early stage of spinal cord injury. SETTING:Japan. METHODS:Urological evaluation, including cystography and urodynamic study was performed in patients in the early stage of spinal cord injury. The patients w...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Suzuki T,Ushiyama T

    更新日期:2001-01-01 00:00:00

  • Bladder cancer in spinal cord injury patients.

    abstract:STUDY DESIGN:Retrospective review. OBJECTIVE:Spinal cord injury is a known risk factor for bladder cancer. The risk of bladder cancer has been reported at 16-28 times higher than the general population. Earlier studies have identified indwelling catheters as risk factors. We examined the characteristics of bladder can...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Kalisvaart JF,Katsumi HK,Ronningen LD,Hovey RM

    更新日期:2010-03-01 00:00:00

  • Testicular responses to hCG stimulation at varying doses in men with spinal cord injury.

    abstract:STUDY DESIGN:Prospective. OBJECTIVES:To test whether provocative stimulation of the testes identifies men with chronic spinal cord injury (SCI), a population in which serum testosterone concentrations are often depressed, possibly due to gonadal dysfunction. To accomplish this objective, conventional and lower than th...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Bauman WA,La Fountaine MF,Cirnigliaro CM,Kirshblum SC,Spungen AM

    更新日期:2017-07-01 00:00:00

  • Evaluation of seminal citrate level by 1H nuclear magnetic resonance spectroscopy in men with spinal cord injury.

    abstract:STUDY DESIGN:A case-control evaluating seminal citrate in patients with spinal cord injury (SCI). OBJECTIVE:Several studies have shown neurological prostatic dysfunction in patients with SCI, as confirmed by low levels of seminal prostate-specific antigen (PSA), which is used as a parameter of gland activity. However,...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Alexandrino AP,Rodrigues MA,Matsuo T,Schuquel IT,Costa WF,Santilli JC

    更新日期:2009-12-01 00:00:00

  • Long-term evolution of blood lipid profiles and glycemic levels in patients after spinal cord injury.

    abstract:OBJECTIVE:To analyze the lipid and glycemic profiles in relation to age, time elapsed post injury and the level of injury in a group of patients with SCI. SUBJECTS:2135 subjects with SCI were recruited during the annual routine health check-up carried out at the Institut Guttmann of Badalona, in Spain. The patients we...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Vidal J,Javierre C,Curià FJ,Garrido E,Lizarraga MA,Segura R

    更新日期:2003-03-01 00:00:00

  • Obesity cutoff values in Korean men with motor complete spinal cord injury: body mass index and waist circumference.

    abstract:STUDY DESIGN:Cross-sectional. OBJECTIVES:To determine the obesity cutoff values for body mass index (BMI) and waist circumference (WC) in Korean men with motor complete spinal cord injury (SCI). SETTING:Tertiary level hospital in Seoul, Korea. METHODS:BMI (kg/m2) was calculated and WC (cm) was measured in each parti...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Yun JH,Chun SM,Kim JC,Shin HI

    更新日期:2019-02-01 00:00:00

  • Pelvic organ prolapse and urogynecological assessment in women with spinal cord injury.

    abstract:STUDY DESIGN:Observational cross-sectional study. OBJECTIVES:Due to weakened pelvic floor muscles, the risk of pelvic organ prolapse (POP) may increase after a spinal cord injury (SCI); hence, the aim of this study was to investigate the occurrence of POP after SCI and to evaluate the need for urogynecological consult...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Elmelund M,Biering-Sørensen F,Bing MH,Klarskov N

    更新日期:2019-01-01 00:00:00

  • Classification of spinal injuries based on the essential traumatic spinal mechanisms.

    abstract:STUDY DESIGN:A biomechanical unitary classification of spinal injuries is proposed. OBJECTIVE:To present an evaluation of spinal injuries based on the essential traumatic spinal mechanisms: axial deformation, torsion, translation and combined mechanisms in connection with the concept of the stabilizing axial spinal pi...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Iencean SM

    更新日期:2003-07-01 00:00:00

  • International spinal cord injury female sexual and reproductive function basic data set.

    abstract:OBJECTIVE:To create the International Spinal Cord Injury (SCI) Female Sexual and Reproductive Function Basic Data Set within the International SCI Data Sets. SETTING:An international working group. METHODS:The draft of the data set was developed by an international working group consisting of members appointed by the...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Alexander MS,Biering-Sørensen F,Elliott S,Kreuter M,Sønksen J

    更新日期:2011-07-01 00:00:00

  • Patient preferences for next generation neural prostheses to restore bladder function.

    abstract:STUDY DESIGN:A survey administered to 66 individuals with spinal cord injury (SCI) implementing a choice-based conjoint (CBC) analysis. Six attributes with three levels each were defined and used to generate choice sets with treatment scenarios. Patients were asked to choose the scenario that they preferred most. OBJE...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Sanders PM,Ijzerman MJ,Roach MJ,Gustafson KJ

    更新日期:2011-01-01 00:00:00

  • Patient selection for an upper extremity neuroprosthesis in tetraplegic individuals.

    abstract::One hundred and twenty persons with new onset traumatic tetraplegia consecutively admitted to our rehabilitation service were screened for consideration for use of an upper extremity neuroprosthesis. Strict inclusion criteria allowed only for participation of patients with ASIA impairment scale A, B or C injuries at t...

    journal_title:Spinal cord

    pub_type: 临床试验,杂志文章


    authors: Gorman PH,Wuolle KS,Peckham PH,Heydrick D

    更新日期:1997-09-01 00:00:00

  • Various surfaces challenge gait characteristics of ambulatory patients with spinal cord injury.

    abstract:STUDY DESIGN:A cross-sectional study. OBJECTIVE:To assess the influence of various surfaces on the gait characteristics of ambulatory participants with incomplete spinal cord injury (SCI) as compared to data from able-bodied participants. SETTING:A tertiary rehabilitation center and communities. METHODS:Seventy part...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Promkeaw D,Arrayawichanon P,Thaweewannakij T,Mato L,Amatachaya P,Amatachaya S

    更新日期:2019-09-01 00:00:00

  • Posterior spinal shortening for paraparesis following vertebral collapse due to osteoporosis.

    abstract:STUDY DESIGN:Retrospective case series. OBJECTIVES:To assess the efficacy of posterior spinal shortening for paraparetic patients following vertebral collapse owing to osteoporosis, especially on instrumentation loosening. SETTING:Department of orthopaedic surgery, Jichi Medical University Hospital and Omiya Medical ...

    journal_title:Spinal cord

    pub_type: 杂志文章


    authors: Saita K,Hoshino Y,Higashi T,Yamamuro K

    更新日期:2008-01-01 00:00:00