Article

Paraplegia (1992) 30, 828–833; doi:10.1038/sc.1992.159

Young spinal cord injured patients in nursing homes: rehospitalization issues and outcomes

S I Weingarden1 and P Graham1

1Southfield Rehab Hospital, 22401 Foster Winter Drive, Southfield, Michigan 48075, USA

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Abstract

Most spinal cord injured (SCI) patients are discharged to their homes and families after they complete their initial rehabilitation program. Nursing homes, however, were the discharge destinations for 3.9% of all SCI patients nationally. When a nursing home is the only discharge option for a young SCI adult, certain economic, medical and psychosocial incongruencies make this placement potentially stressful for both the nursing home staff and the young patient. This study of the rehospitalization of 12 SCI patients under the age of 50 who were discharged to nursing homes explores the issues of cost, care and outcome during their first year following nursing home admission. Nine of the 12 patients were rehospitalized a total of 21 times, mainly for urinary tract infections and decubiti. Charges for 18 of these 21 rehospitalizations amounted to over $423,110 for 599 days of care. Four of these 9 patients died before the end of the first year. Although this is a retrospective study of the medical records and follow up data for a small key group of SCI patients, it calls attention to the need for continued investigation into the outcomes of a minimally visible population that lacks advocacy for change.

Keywords:

spinal cord injury; post hospital care; rehospitalization; nursing home care

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References

  1. Trieschmann R (1988) Spinal Cord Injuries: Psychological, Social and Vocational Rehabilitation. Demos, New York: 26.
  2. Libow L S, Starer P (1989) Care of the nursing home patient. TV Engl J Med 321: 93–96.
  3. Davidoff G, Schultz J S, Lieb T, Andrews K, Wardner J, Hayes C et al (1990) Rehospitalization after rehabilitation for acute spinal cord injury: incidence and risk factors. Arch Phys Med Rehab 71: 121–124.
  4. Stover S L, Fine P R, editors. Spinal Cord Injury: The Facts and Figures. University of Alabama Press, Birmingham.
  5. Djikers M, Graham P (1985) The Potential for Nursing Home Placement of SCI Patients: A Survey of Michigan Nursing Homes. American Spinal Injury Association, Atlanta.
  6. Ulmer D (1990) Special needs of the young spinal cord injured patient in a nursing home. SCI Nursing 7: 27–30. | PubMed |