title: Time-series analysis of the barriers for admission into a spinal rehabilitation unit.
abstract: METHODS
  This is a prospective open-cohort case series.
  
  
  OBJECTIVE
  The objective of this study was to assess changes over time in the duration of key acute hospital process barriers for patients with spinal cord damage (SCD) from admission until transfer into spinal rehabilitation unit (SRU) or other destinations.
  
  
  METHODS
  The study was conducted in Acute hospitals, Victoria, Australia (2006-2013).
  
  
  METHODS
  Duration of the following discrete sequential processes was measured: acute hospital admission until referral to SRU, referral until SRU assessment, SRU assessment until ready for SRU transfer and ready for transfer until SRU admission. Time-series analysis was performed using a generalised additive model (GAM). Seasonality of non-traumatic spinal cord dysfunction (SCDys) was examined.
  
  
  RESULTS
  GAM analysis shows that the waiting time for admission into SRU was significantly (P<0.001) longer for patients who were female, who had tetraplegia, who were motor complete, had a pelvic pressure ulcer and who were referred from another health network. Age had a non-linear effect on the duration of waiting for transfer from acute hospital to SRU and both the acute hospital and SRU length of stay (LOS). The duration patients spent waiting for SRU admission increased over the study period. There was an increase in the number of referrals over the study period and an increase in the number of patients accepted but not admitted into the SRU. There was no notable seasonal influence on the referral of patients with SCDys.
  
  
  CONCLUSIONS
  Time-series analysis provides additional insights into changes in the waiting times for SRU admission and the LOS in hospital for patients with SCD.
authors.affiliation: Spinal Rehabilitation Service, Caulfield Hospital, Alfred Health, Melbourne, Victoria, Australia.|Principal Researcher, Epworth-Monash Rehabilitation Medicine Unit, Monash University, Melbourne, Victoria, Australia.|Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: P W
authors.initials: PW
authors.lastname: New
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Akram
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D004608:Eligibility Determination / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D017678:Sex Distribution; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000534:rehabilitation*; D014739:Victoria / Q000453:epidemiology; D014850:Waiting Lists; D055815:Young Adult