[The influence of complications on rehabilitation of spinal cord injuries: economical minus effects and physical disadvantages caused by urinary tract infection and decubitus ulcer].
There are few studies on the many complications that disrupt the rehabilitation of patients with cervical cord injuries and their subsequent health-economic benefits. I particularly focused on the treatment of urinary tract infection and decubitus ulcers because these are very frequently encountered complications in a clinical setting. I examined how these complications affect the progress of rehabilitation and facilitate a patient's return to society. The subjects included ninety-eight cervical cord injury patients with tetraplegia who were discharged from the Rehabilitation Center for Severely Disabled Persons from 1995 to 2000. I retrospectively investigated these ninety-eight subjects regarding ninety-six items from clinical records, among which twenty items were selected because they are considered to be closely associated with outcome, such as age, sex, length of stay, medical expense, urinary tract infection, and decubitus ulcer. Moreover, I examined the influence that urinary tract infection and decubitus ulcer had on other items. The average length of stay and total medical expenses per patient were 1,174.4 +/- 559.9 days and 13,563,128.4 +/- 6,351,078.1 yen, respectively. Urinary tract infection and decubitus ulcer occurred at a rate of 97% in patients with cervical cord injury undergoing chronic stage rehabilitation, and these complications caused a two-fold prolongation of the length of stay and a three-fold increase in medical expenses compared with patients without complications. It is important to fully recognize that these complications produce many expenses as well as those for the medical treatment of cervical cord injury.
Kitagawa
Tsunemi
T
Department of Health Services Administration, Nippon Medical School, Japan. t-kita@nms.ac.jp
Kimura
Tetsuhiko
T
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer / Q000209:etiology*; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications* / Q000191:economics / Q000534:rehabilitation*; D014552:Urinary Tract Infections / Q000209:etiology*