Specialized Care for Spinal Cord Injury: Impact on Functional Outcomes, Secondary Medical Complications and Length of Stay

Background/purpose: The most recent incidence studies of SCI in the US estimate that there are 12,000 new cases of injury survivors per year with an estimated prevalence of 270,000. Approximately 13% of new SCI patients are provided services at one of 14 federally funded Spinal Cord Injury Models Systems Hospitals (SCIMS) (Spinal Cord Facts 2012). The purpose of this review is to identify whether or not individuals with Spinal Cord Injury who receive services within a specialized system of care, such as that provided at the SCIMS hospitals, have better functional outcomes, decreased length of stay and/or decreased incidence of secondary medical complications. Case Description: A data base review of PubMed, CINAHL plus with full text, REHABDATA, Cochrane, and PEDro was conducted using combinations of the following key words: spinal cord injury, outcomes, functional outcomes, length of stay, specialized, specialised, organized, organised, skilled nursing facility, rehabilitation, and complications.. Outcomes and Discussion: Research from the US SCIMS hospitals and specialized SCI centers in other countries has provided very low quality evidence that specialized and integrated SCI care, from onset of injury through community reintegration, reduces secondary medical complications and length of stay and concomitantly increases functional outcomes at discharge. No research has been identified which attempts to fetter out which specific qualities or characteristics of model systems contribute to these improved outcomes