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  1. Article ; Online: Does stronger primary care improve access to health services for persons with spinal cord injury? Evidence from eleven European countries.

    Bychkovska, Olena / Tederko, Piotr / Strøm, Vegard / Juocevicius, Alvydas / Gemperli, Armin

    The journal of spinal cord medicine

    2023  , Page(s) 1–11

    Abstract: Objective: To determine the association between the strength of primary care and perceived access to follow-up care services among persons with chronic spinal cord injury (SCI).: Design: Data analysis of the International Spinal Cord Injury (InSCI) ... ...

    Abstract Objective: To determine the association between the strength of primary care and perceived access to follow-up care services among persons with chronic spinal cord injury (SCI).
    Design: Data analysis of the International Spinal Cord Injury (InSCI) cross-sectional, community-based questionnaire survey conducted in 2017-2019. The association between the strength of primary care (Kringos
    Setting: Community in eleven European countries: France, Germany, Greece, Italy, Lithuania, the Netherlands, Norway, Poland, Romania, Spain and Switzerland.
    Participants: 6658 adults with chronic SCI.
    Intervention: None.
    Outcome measures: Share of persons with SCI that reported unmet healthcare needs as a measure of access.
    Results: Twelve percent of the participants reported unmet healthcare needs: the highest in Poland (25%) and lowest in Switzerland and Spain (7%). The most prevalent access restriction was service unavailability (7%). Stronger primary care was associated with lower odds of reporting unmet healthcare needs, service unavailability, unaffordability and unacceptability. Females, persons of younger age and lower health status, had higher odds of reporting unmet needs.
    Conclusions: In all investigated countries, persons with chronic SCI face access barriers, especially with service availability. Stronger primary care for the general population was also associated with better health service access for persons with SCI, which argues for further primary care strengthening.
    Language English
    Publishing date 2023-03-27
    Publishing country England
    Document type Journal Article
    ZDB-ID 1223949-5
    ISSN 2045-7723 ; 1079-0268
    ISSN (online) 2045-7723
    ISSN 1079-0268
    DOI 10.1080/10790268.2023.2188390
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Healthcare service utilization patterns and patient experience in persons with spinal cord injury: a comparison across 22 countries.

    Bychkovska, Olena / Tederko, Piotr / Engkasan, Julia Patrick / Hajjioui, Abderrazak / Gemperli, Armin

    BMC health services research

    2022  Volume 22, Issue 1, Page(s) 755

    Abstract: Background: Persons with spinal cord injury frequently visit numerous clinical settings. Such all-around experience of the system may serve as a comprehensive experience indicator. This study compared the patient experience of persons with chronic SCI ... ...

    Abstract Background: Persons with spinal cord injury frequently visit numerous clinical settings. Such all-around experience of the system may serve as a comprehensive experience indicator. This study compared the patient experience of persons with chronic SCI in relation to healthcare service utilization patterns in 22 countries, hypothesizing that primary-care oriented patterns would offer a better experience.
    Methods: This study was based on International Spinal Cord Injury Survey with 12,588 participants across 22 countries worldwide. Utilization patterns/clusters were identified by cluster analysis and experience score - by the partial credit model. The association between healthcare utilization and experience at the provider and cluster level was explored by regression analysis.
    Results: The highest share of visits was to primary care physicians (18%) and rehabilitation physicians (16%). Utilization patterns had diverse orientations: from primary care to specialized and from inpatient to outpatient. The experience was reported as very good and good across different dimensions: 84% reported respectful treatment; 81% - clear explanations; 77% - involvement in decision making; 65% - satisfaction with care. The average experience score (0-100) was 64, highest - 74 (Brazil) and the lowest - 52 (Japan, South Korea). Service utilization at provider and at cluster levels were associated with patient experience, but no utilization pattern resulted in uniformly better patient experience.
    Conclusion: While there are distinct patterns between countries on how persons with chronic SCI navigate the healthcare system, we found that different utilization patterns led to similar patient experience. The observed difference in patient experience is likely determined by other contextual factors than service utilization.
    MeSH term(s) Delivery of Health Care ; Humans ; Inpatients ; Patient Acceptance of Health Care ; Patient Outcome Assessment ; Spinal Cord Injuries/epidemiology ; Spinal Cord Injuries/therapy
    Language English
    Publishing date 2022-06-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 2050434-2
    ISSN 1472-6963 ; 1472-6963
    ISSN (online) 1472-6963
    ISSN 1472-6963
    DOI 10.1186/s12913-022-07844-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Health System's Role in Facilitating Health Service Access among Persons with Spinal Cord Injury across 22 Countries.

    Bychkovska, Olena / Strøm, Vegard / Tederko, Piotr / Engkasan, Julia Patrick / Juocevičius, Alvydas / Battistella, Linamara Rizzo / Arora, Mohit / Egen, Christoph / Gemperli, Armin

    International journal of environmental research and public health

    2023  Volume 20, Issue 11

    Abstract: 1) Background: Despite efforts to improve access to health services, between- and within-country access inequalities remain, especially for individuals with complex disabling conditions like spinal cord injury (SCI). Persons with SCI require regular ... ...

    Abstract (1) Background: Despite efforts to improve access to health services, between- and within-country access inequalities remain, especially for individuals with complex disabling conditions like spinal cord injury (SCI). Persons with SCI require regular multidisciplinary follow-up care yet experience more access barriers than the general population. This study examines health system characteristics associated with access among persons with SCI across 22 countries. (2) Methods: Study data are from the International Spinal Cord Injury Survey with 12,588 participants with SCI across 22 countries. Cluster analysis was used to identify service access clusters based on reported access restrictions. The association between service access and health system characteristics (health workforce, infrastructure density, health expenditure) was determined by means of classification and regression trees. (3) Results: Unmet needs were reported by 17% of participants: lowest (10%) in Japan, Spain, and Switzerland (cluster 1) and highest (62%) in Morocco (cluster 8). The country of residence was the most important factor in facilitating access. Those reporting access restrictions were more likely to live in Morocco, to be in the lowest income decile, with multiple comorbidities (Secondary Conditions Scale (SCI-SCS) score > 29) and low functioning status (Spinal Cord Independence Measure score < 53). Those less likely to report access restriction tended to reside in all other countries except Brazil, China, Malaysia, Morocco, Poland, South Africa, and South Korea and have fewer comorbidities (SCI-SCS < 23). (4) Conclusions: The country of residence was the most important factor in facilitating health service access. Following the country of residence, higher income and better health were the most important facilitators of service access. Health service availability and affordability were reported as the most frequent health access barriers.
    MeSH term(s) Humans ; Spinal Cord Injuries/epidemiology ; Spinal Cord Injuries/therapy ; Health Services Accessibility ; Disabled Persons/rehabilitation ; Surveys and Questionnaires ; Switzerland
    Language English
    Publishing date 2023-06-05
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2175195-X
    ISSN 1660-4601 ; 1661-7827
    ISSN (online) 1660-4601
    ISSN 1661-7827
    DOI 10.3390/ijerph20116056
    Database MEDical Literature Analysis and Retrieval System OnLINE

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