Rehabilitation Evidence > Primary Care > Key Points

Key Points

Submitted by admin on Fri, 05/21/2010 - 17:54
  • A large majority of people with spinal cord injuries have a family doctor and are satisfied with care received.
  • People with spinal cord injuries tend to be high users of primary care.
  • Lack of SCI-specific expertise appears to be the greatest impediment to accessing primary care.  Physical barriers are also encountered in some practices.
  • Unmet health needs are a significant problem for people with SCI in primary care, with information needs in particular being poorly met. 
  • There is no concensus about the role of physiatry in primary care.  While many people with SCI are content to receive their primary care from a physiatrist, there is some question as to whether physiatrists are the appropriate primary care provider. 
  • Coordination is needed to ensure continuity and coverage when multiple providers are involved.
  • There is conflicting evidence about the effectiveness of outreach programs for maintaining health in the community with SCI.
  • There is a high level of consistency in identifying the most common issues raised by people with spinal cord injuries in primary care.  
  • The majority of the issues raised in primary care are disability-related – specifically, they are secondary complications of the spinal cord injury. 
  • The most commonly raised issues are bowel, bladder and pain.  Also of significant concern are skin care, equipment and medication needs, depression and bone density.
  • Unmet needs in primary care pertain primarily to psychological issues, sexual and reproductive health, health promotion and lifestyle, and information needs.