Processes of care and outcomes after traumatic spinal cord injury in Sweden and : South Africa; a quality assurance study

Purpose

To evaluate the impact of the SCI management model in terms of healthcare efficiency and patient-specific outcomes from 2006-2018, in order to provide an evidence-based foundation to facilitate good quality SCI-care in the Greater Stockholm County Sweden and 

Project description

In Sweden, a systematic approach towards the management of TSCI was initiated around the 1970’s, and a spinal cord management model was started in the 1990’s here in Stockholm. The care for persons with TSCI follows a specific pathway in Stockholm, Sweden, where newly-injured individuals receive the necessary surgical intervention as soon as possible following injury and then receive primary rehabilitation, and finally out-patient rehabilitation as offered by Aleris Rehab Station and the SCI-unit Spinalis. This model further incorporates lifelong follow up by providing specialist consultation regularly. Previous research has shown that such a system results in significantly lower death rates, fewer complications, better functional outcomes and health-related quality of life. During the last decades some studies have focus on outcomes from the SCI care of chain in Stockholm. Still since the introduction of this system, little is known about the impact of this management model in Stockholm with regard to health care efficiency (i.e length of hospital stay, absence of secondary complications during all changes of management), and patient-oriented outcomes, such as functional independence, societal reintegration/participation and return-to-work.

Unlike this, the South African healthcare system is in the process of strengthening its health system for people suffering from disabling conditions such as SCI. In order to inform the structure and process aspects, it seems necessary to describe the nature of processes of system which had proved itself over the years – the Swedish system for SCI management. In addition, it is important to assess the relationship between these processes and outcomes, which could provide further incentives for policy makers on the implementation of certain key processes. This multi-continent study could provide evidence for further strengthening systems of care.

Delprojekt

Projektet är en fortsättning på en tidigare publicerad avhandling; Traumatic Spinal Cord Injury in South Africa and Sweden: Epidemiologic features and functioning

Presentations

Presentationer från tidigare delprojekt; Traumatic Spinal Cord Injury in South Africa and Sweden: Epidemiologic features and functioning

Joseph C, Seiger Å, Nilsson Wikmar L, Hultling C, Wahman K. Processes and outcomes of acute care: towards strengthening health systems for survivors of traumatic spinal cord injury in South Africa. Poster presentation at the International Spinal Cord Society conference (Vienna, Austria, September 2016)

Joseph C, Wahman K, Nilsson Wikmar L. Acute medical complications and risk factors for pressure ulcers after traumatic spinal cord injury: how specialized are we in South Africa? Poster presentation at the World Confederation of Physical Therapy (WCPT), Singapore (May 2015).

Joseph C, Nilsson Wikmar L. Living with a long-term traumatic spinal cord injury in South Africa: experiences related to readjustment and attained participation (self-perceived). Poster presentation at the World Confederation of Physical Therapy (WCPT), Singapore (May 2015).

Joseph C, Phillips J, Wahman K, Nilsson Wikmar L. Unveiling the incidence and aetiology of TSCI in South Africa: is it any different? Poster presentation at the joint ISCoS/ASIA meeting in Montreal Canada (May 2015).

Publications

Secondary medical complications after traumatic spinal cord injury in Stockholm, Sweden: Towards developing prevention strategies 
Journal of rehabilitation medicine, 2019, Vol.51 (7), p.513-517
Wahman, Kerstin ; Wikmar, Lena Nilsson ; Chlaidze, Giorgi ; Joseph, Conran