title: A comparative analysis of individuals with spinal cord injury who differ in unplanned utilization of health services.
abstract: The purpose of this descriptive study is to describe the profile of individuals with spinal cord injuries (SCI) who frequently use health care services in an unplanned manner so that nursing interventions could be designed to decrease utilization. The medical records of 78 subjects with SCI were reviewed for demographic and injury-related variables, comorbid health conditions, discharge disposition, and health care utilization for five years. Based on the rate of unplanned utilization of health care services, three groups of users were identified: non-user, low-user, and high-user groups. Results indicated that high users, compared to non-users and low users, had a higher substance-use rate, a higher unemployment rate at the time of the most recent health care visit, and more violent causes of their SCI. Findings suggest four clinically meaningful trends that have practical implications for nurses related to marital status, substance use, employment status, and etiology of injury. Results of this study laid the foundation for future research aimed at devising a more in-depth risk profile of high users of health care services in the SCI population.
authors.affiliation: MetroHealth Medical Center, Cleveland, USA.
authors.forename: N M
authors.initials: NM
authors.lastname: Wineman
authors.forename: E
authors.initials: E
authors.lastname: Leffler
authors.forename: R M
authors.initials: RM
authors.lastname: Radziewicz
authors.forename: C
authors.initials: C
authors.lastname: Sams
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009820:Ohio; D012189:Retrospective Studies; D012944:Social Support; D013119:Spinal Cord Injuries / Q000150:complications / Q000628:therapy*