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Examining the impact of the COVID-19 pandemic on homecare services among individuals with traumatic and non-traumatic spinal cord injuries

Spinal Cord volume 62, pages 406–413 (2024)Cite this article

Subjects

Abstract

Study design

Descriptive repeated-cross sectional retrospective longitudinal cohort study.

Objective

To investigate the impact of the COVID-19 pandemic on homecare services in individuals with traumatic or non-traumatic Spinal Cord Injury (SCI).

Setting

Health administrative database in Ontario, Canada.

Methods

A repeated cross-sectional study using linked health administrative databases from March 2015 to June 2022. Monthly homecare utilization was assessed in 3381 adults with SCI using Autoregressive Integrated Moving Average (ARIMA) models.

Results

Compared to pre-pandemic levels, between March 2020 to June 2022, the traumatic group experienced a decrease in personal and/or homemaking services, as well as an increase in nursing visits from April 2020–March 2022 and June 2022. Case management increased at various times for the traumatic group, however therapies decreased in May 2020 only. The non-traumatic group experienced a decrease in personal and/or homemaking services in July 2020, as well as an increase in nursing visits from March 2020 to February 2021 and sporadically throughout 2020. Case management also increased at certain points for the non-traumatic group, but therapies decreased in April 2020, July 2020, and September 2021.

Conclusion

The traumatic group had decreases in personal and/or homemaking services. Both groups had increases in nursing services, increases in case management, and minimal decreases in therapies at varying times during the pandemic. Investigation is warranted to understand the root cause of these changes, and if they resulted in adverse outcomes.

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Fig. 1: Personal/Homemaking Homecare Services for Spinal Cord Cohort.
Fig. 2: Nursing Homecare Services for Spinal Cord Cohort.
Fig. 3: Case Management Homecare Services for Spinal Cord Cohort.
Fig. 4: Therapies Homecare Services for Spinal Cord Cohort.

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Data availability

The dataset from this study is held securely in coded form at ICES. While legal data sharing agreements between ICES and data providers (e.g., healthcare organizations and government) prohibit ICES from making the dataset publicly available, access may be granted to those who meet pre-specified criteria for confidential access, available at www.ices.on.ca/DAS (email: das@ices.on.ca). The full dataset creation plan and underlying analytic code are available from the authors upon request, understanding that the computer programs may rely upon coding templates or macros that are unique to ICES and are therefore either inaccessible or may require modification.

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Acknowledgements

This study was supported by ICES (formerly named the Institute for Clinical Evaluative Sciences), an independent, non-profit research institute funded by an annual grant from the Ontario Ministry of Health (MOH) and the Ministry of Long-Term Care (MLTC). As a prescribed entity under Ontario’s privacy legislation, ICES is authorized to collect and use health care data for the purposes of health system analysis, evaluation, and decision support. Secure access to these data are governed by policies and procedures approved by the Information and Privacy Commissioner of Ontario. This document used data adapted from the Statistics Canada Postal CodeOM Conversion File, which is based on data licensed from Canada Post Corporation, and/or data adapted from the Ontario Ministry of Health Postal Code Conversion File, which contains data copied under license from Canada Post Corporation and Statistics Canada. Parts of this material are based on data and/or information compiled and provided by the Ontario Ministry of Health, and the Canadian Institute for Health Information. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. Parts of this material are based on data and information provided by Ontario Health (OH). The opinions, results, view, and conclusions reported in this paper are those of the authors and do not necessarily reflect those of OH. No endorsement by OH is intended or should be inferred. Dr. Guilcher is currently supported by the University of Toronto Centre for the Study of Pain Scientist Salary Award. Dr. Karen Tu is supported by a Chair in Family and Community Medicine Research in Primary Care at UHN and a Research Scholar award from the Department of Family and Community Medicine at the University of Toronto. Dr B. Catharine Craven is supported by UHN Foundation in her role as the University of Toronto/University Health Network COPE Family Chair in SCI Health Services Innovation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Funding

This study was funded as part of a CIHR operating grant (#478336). The opinions, results, and conclusions reported in this paper are those of the authors and are independent from the funding sources.

Author information

Authors and Affiliations

  1. Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada

    Arrani Senthinathan, Mina Tadrous, Swaleh Hussain, Lauren Cadel & Sara J. T. Guilcher

  2. Women’s College Hospital Institute for Health Systems Solutions and Virtual Care, Women’s College Hospital, Toronto, ON, Canada

    Mina Tadrous & Cherry Chu

  3. ICES, Toronto, ON, Canada

    Swaleh Hussain, Rahim Moineddin, Susan B. Jaglal & Sara J. T. Guilcher

  4. VHA Home HealthCare, Toronto, ON, Canada

    Sandra McKay

  5. Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada

    Sandra McKay, Susan B. Jaglal, B. Catharine Craven & Sara J. T. Guilcher

  6. Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Sandra McKay, Susan B. Jaglal & Sara J. T. Guilcher

  7. Ted Rogers School of Management, Toronto Metropolitan University, Toronto, ON, Canada

    Sandra McKay

  8. Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada

    Rahim Moineddin & Karen Tu

  9. Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada

    Susan B. Jaglal & John Shepherd

  10. KITE (Knowledge Innovation Talent Everywhere), Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada

    John Shepherd & B. Catharine Craven

  11. Praxis Spinal Cord Institute, Vancouver, BC, Canada

    Vanessa K. Noonan

  12. International Collaboration on Repair Discoveries, Vancouver, BC, Canada

    Vanessa K. Noonan

  13. Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    B. Catharine Craven

  14. Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute – University Health Network, Toronto, ON, Canada

    B. Catharine Craven

  15. North York General Hospital, Toronto, ON, Canada

    Karen Tu

  16. Toronto Western Family Health Team, University Health Network, Toronto, ON, Canada

    Karen Tu

Authors
  1. Arrani Senthinathan
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Contributions

SJTG and AS conceptualized the study. SJTG, JS, BCC, KT, SJ, RM, LC, VN, and SM helped acquire the funding for this study. SH abstracted the associated data for this study from databases. AS, SJTG, and MT prepared, coordinated, and guided the data analyses. CC conducted the data analysis. AS, SJTG, and SM interpreted the findings. AS wrote the first draft of the manuscript, as well as, created all associated figures and tables. All authors critically reviewed and approved the manuscript.

Corresponding author

Correspondence to Arrani Senthinathan.

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The authors declare no competing interests.

Ethics approval

Section 45 of PHIPA authorizes ICES to collect personal health information, without consent, for the purpose of analysis or compiling statistical information with respect to the management of, evaluation or monitoring of, the allocation of resources to or planning for all or part of the health system. Projects that use data collected by ICES under section 45 of PHIPA, and use no other data, are exempt from REB review. The use of the data in this project is authorized under section 45 and approved by ICES’ Privacy and Legal Office (#2023 0904 527 000).

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Senthinathan, A., Tadrous, M., Hussain, S. et al. Examining the impact of the COVID-19 pandemic on homecare services among individuals with traumatic and non-traumatic spinal cord injuries. Spinal Cord 62, 406–413 (2024). https://doi.org/10.1038/s41393-024-00999-2

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