title: Developing quality of care indicators for patients with traumatic and non-traumatic spinal cord injury (SCI): A feasibility study using administrative health data.
abstract: OBJECTIVE
  (1) to inform the development of health system quality indicators for traumatic and non-traumatic spinal cord injury from acute care admission to community care discharge using administrative data, and (2) to examine characteristics and differences in care among type of care facility, and type of pathology using administrative data.
  
  
  METHODS
  Retrospective cohort study using administrative health data.
  
  
  METHODS
  Ontario, Canada.
  
  
  METHODS
  Using administrative health data, we used International Classification codes 10(th) version Canadian Edition to identify incident cases of SCI from April 1, 2006 to March 31, 2012.
  
  
  RESULTS
  We identified 7,693 cases in our cohort, of whom 1,537 (20.0%) were categorized as traumatic spinal cord (TSCI) and 6,156 (80.0%) as non-traumatic (NTSCI). Of those identified with NTSCI, more than half (54.0%) were diagnosed with either Guillain Barré syndrome and Multiple Sclerosis (n = 3,326). More individuals admitted to a trauma/spine center were seen by an orthopedic surgeon or a neurosurgeon (20.3% compared to 5.6% for NTSCI; 77.7% compared to 24.9% for TSCI). Only 25.7% (n = 724) of the NTSCI cohort were admitted to a rehabilitation facility from a trauma/spine center, compared to 58.9% (n = 754) of those with TSCI.
  
  
  CONCLUSIONS
  Important challenges in data completeness and utility were identified. Province wide processes to flag incomplete data and provision of incentives for comprehensive data are urgently needed to develop quality indicators across the care continuum. Consensus on the coding for NTSCI for the purposes of developing health system indicators is required.
authors.forename: Sara J T
authors.initials: SJ
authors.lastname: Guilcher
authors.forename: Daria
authors.initials: D
authors.lastname: Parsons
authors.forename: B Catharine
authors.initials: BC
authors.lastname: Craven
authors.forename: Susan B
authors.initials: SB
authors.lastname: Jaglal
authors.forename: Molly
authors.initials: M
authors.lastname: Verrier
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D019984:Quality Indicators, Health Care / Q000592:standards* / Q000706:statistics & numerical data; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000534:rehabilitation / Q000628:therapy*; D014193:Trauma Centers / Q000706:statistics & numerical data
keywords: Diagnostic codes; Health care quality; Health system quality indicators; Spinal cord injury