Article

OBJECTIVE: To determine whether an evidence-based wellness program for
individuals with spina bifida and spinal cord injury would improve health
outcomes and patient experience of care, result in a positive return on
investment (ROI), and provide evidence for scalability.
DESIGN: Nonrandomized,
noncontrolled cohort study; 2 years of enrollment.
SETTING: Academic
hospital-based outpatient physiatry clinic partnered with an insurance division
within an integrated health care delivery and financing system. PARTICIPANTS:
Individuals (N=69) with spina bifida and spinal cord injury were consented; 4
were excluded (5.7%), and the remaining 65 (94.2%) participated in the
intervention. INTERVENTIONS: Evidence-based wellness program consisting of care
coordination from a mobile nurse, patient education, and patient incentives. MAIN
OUTCOME MEASURES: Validated measures of function, mood, quality of life, and
perception of care delivery; knowledge of preventable conditions; self-rating of
health; and utilization and cost. RESULTS: Improvements in all main outcome
measures were seen after 2 years of enrollment. Although cost in year 1 of
enrollment increased because of hospitalizations and the overall ROI was
negative, a small positive ROI was seen in year 2 of enrollment. CONCLUSIONS:
Participation in an evidence-based wellness program was associated with improved
health and experience of care. Scaling the program to larger numbers may result
in an overall positive ROI.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS