On Tuesday, May 29, 2012 at 3 PM, Lee L. Saunders, PhD. of the Medical University of South Carolina (MUSC) and the Rehabilitation Research and Training Center (RRTC) presented a webinar entitled “Health Care Access After Spinal Cord Injury”. The contents of the webinar were developed under grants from the Department of Education’s National Institute on Disability and Rehabilitation Research (NIDRR) and the National Institutes of Health (NIH).
At the beginning of the webinar, spinal cord injury (SCI) was defined as resulting “in immediate and general permanent changes in sensory, motor, bowel, bladder, and sexual function” with a “risk of secondary conditions and early mortality.” Several statistics were also included: there are about 12,000 new cases per year, about 265,000 people are living with SCI in the US, the average age at the time of injury is 40.7 years, 80.7% are male, 66.5% are Caucasian, and 26.8% are African-American. The definition and statistics come from Facts and Figures 2011, National Spinal Cord Injury Statistical Center. Health Care Access (HCA) was also defined: HCA is the ability of a person to receive health care services in relation to the availability of personnel and supplies and the ability to pay for services.
Two studies were presented during the webinar. The first is “Association of Race, Socioeconomic Status, and Health Care Access with Pressure Ulcers after SCI” by L.L. Saunders, J.S. Krause, and J. Acuna (2012) which assessed the association of race, socioeconomic status (SES), and HCA with pressure ulcer (PrU) outcomes. A survey of traumatic SCI survivors found that socioeconomic status (SES) remained significantly associated with PrU outcomes after SCI even after HCA was accounted for. They also found that, there was no relationship found between race or education and PrU outcomes after controlling for income. Health care providers should be aware of the increased risk of PrU in their clients with lower SES. The second study is “Healthcare Access after Spinal Cord Injury: A Comparison with the General Population”, whose objective was to identify the extent to which African-Americans with SCI have equal HCA compared to African-Americans in the general population. The study used the 2009 Behavioral Risk Factor Surveillance System questionnaire from the CDC to survey African Americans with SCI who were 18 years or older residing in South Carolina. The survey gathered data on types of healthcare coverage, access to physicians and other healthcare professionals, and length of time since the last checkup. The study concluded that people with SCI are a vulnerable population because of reduced access to providers and insufficient coverage, and that reduced access to health care could create even wider disparities in health outcomes.
The presenters of the webinar suggest future studies with expanded measures of health care coverage and that produce longitudinal data to assess changes in health care access and coverage. For more information please visit the MUSC website, which includes information about this webinar, the Spinal Cord Injury Research Team, the RRTC, and other funded projects relating to spinal cord injury.