Article

Objectives:Describe and compare the organisation and delivery
of rehabilitation services and systems of care for patients with spinal cord
injury (SCI).Setting:International. Nine spinal rehabilitation units that manage
traumatic SCI and non-traumatic SCI (NTSCI) patients.Methods:Survey based on
clinical expertise and literature review. Completed between November 2010 and
April 2011.Results:All units reported public/government funding. Additional
funding sources included compensation schemes, private insurance and self
funding. Six units had formal attachment to an acute SCI unit. Five units (Italy,
Ireland, India, Pakistan and Switzerland) provided a national service; two units
(the Netherlands and USA) provided regional and two units (Australia and Canada)
provided state/provincial services. The median number of SCI rehabilitation beds
was 23 (interquartile range=16-30). All units admitted both traumatic SCI and
NTSCI patients. The median proportion of patients admitted who had traumatic SCI
was 45% (IQR 20-48%) and 40% (IQR 30-42%) had NTSCI. The rehabilitation team in
all centres determined patient readiness for discharge. There was great
variability between units in the availability of SCI speciality services,
ancillary services and staff/patient ratios.Conclusion:There was a wide range of
differences in the organisation, systems of care and services available for
patients with SCI in rehabilitation units in different countries. Understanding
these differences is important when comparing patient outcomes from different
settings. A standardised collection of these system variables should be
considered as part of future studies and could be included in the ISCoS data set
project.

Langue : ANGLAIS