title: Influence of socio-economic status on access to different components of SCI management across Indian population.
abstract: OBJECTIVE
  To assess the influence of financial constraints on access to different components of spinal cord injury (SCI) management in various socio-economic strata of the Indian population.
  
  
  METHODS
  Indian Spinal Injuries Centre (ISIC).
  
  
  METHODS
  One hundred fifty SCI individuals who came for follow-up at ISIC between March 2009 and March 2013 with at least 1 year of community exposure after discharge were included in the study. Socio-economic classification was carried out according to the Kuppuswamy scale, a standard scale for the Indian population. A self-designed questionnaire was administered.
  
  
  RESULTS
  No sample was available from the lower group. There was a statistically significant difference (P<0.05) for the levels of difficulty perceived by different socio-economic groups in accessing different components of SCI management. Aided upper lower group was dependent on welfare schemes for in-hospital treatment but could not access other components of management once discharged. Unaided upper lower group either faced severe difficulty or could not access management. Majority of lower middle group faced severe difficulty. Upper middle group was equally divided into facing severe, moderate or no difficulty. Most patients in the upper group faced no difficulty, whereas some faced moderate and a small number of severe difficulty.
  
  
  CONCLUSIONS
  Financial constraints affected all components of SCI management in all except the upper group. The results of the survey suggest that a very large percentage of the Indian population would find it difficult to access comprehensive SCI management and advocate extension of essential medical coverage to unaided upper lower, lower middle and upper middle groups.
authors.affiliation: Spine Service, Indian Spinal Injuries Center, New Delhi, India.
authors.forename: H S
authors.initials: HS
authors.lastname: Chhabra
authors.affiliation: Clinical Research, Indian Spinal Injuries Center, New Delhi, India.
authors.forename: A M
authors.initials: AM
authors.lastname: Bhalla
mesh_terms: D000328:Adult; D019468:Disease Management; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D012923:Social Class; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D011795:Surveys and Questionnaires; D055815:Young Adult