Rehabilitation Evidence > Primary Care > Summary

Summary

Submitted by admin on Fri, 05/21/2010 - 17:50
  • There is level 5 evidence that half of those with a perceived need for physical rehabilitation received it; significant predicting factors of access to health services include health plan type, health condition, health status, severity of condition, income level and age (Beatty et al., 2003).
  • There is level 5 evidence that an annual Comprehensive Preventive Health Evaluation conducted at the SCI centre is related to improved health care utilization and having health, psychosocial, and equipment needs met (Collins 2005).
  • There is level 5 evidence that 40% physiatrists are willing to provide primary care to those with disabilities;  38% feel prepared by residency training to do so (Francisco et al., 1995).
  • There is level 5 evidence that there is considerable duplication between primary care and physiatry;  there is high satisfaction with primary care and physiatry; (Donnelly et al., 2007).
  • There is level 5 evidence that there are significant differences in service utilization between Canadians, Americans, and Britons, but no difference in access to and satisfaction with the services (Donnelly et al., 2007).
  • There is level 4 evidence that GP utilization is related to older age, complications and chronic care living (Munce et al., 2009)
  • There is level 4 evidence that individuals living in more rural areas are twice as likely to visit the Emergency Department than those living in cities (Munce et al 2009).
  • There is level 5 evidence that barriers to specialized multi-disciplinary outreach service are limited local expert knowledge, lack of funding, service fragmentation (Cox, 2001)
  • There is level 5 evidence that half of SCI out-patients consider physiatry as primary care; 90% have little difficulty receiving medical care in the community (Bockeneck, 1997).
  • There is level 5 evidence that 75% of people with SCI have multiple clinical problems; patients made an average of 4 GP visits and received average 4.5 home visits (Glickman et al., 1996)
  • There is level 2 evidence that an outreach program (Transmural care - nurse liaison from rehab to primary care) does not appear to be effective in reducing pressure sores, urinary tract infections or hospital re-admission rates  (Bloemen-Vrencken et al. 2007)
  • There is level 4 evidence that clinician adherence to bowel and bladder guidelines improves with targeted implementation plan (Goetz et al 2005).
  • There is level 4 evidence that outreach in the form of home visits from a multidisciplinary team  from the rehab centre led to fewer re-admissions and improved rehab outcomes (Prabhaka et al. 2003). 
  • There is level 4 evidence that a multidisciplinary Health Maintenance Education outreach program improves patient satisfaction with primary care and increases knowledge of respiratory complications, autonomic hyperreflexia, spasticity, aging and community resources (Beck & Scroggins, 2001).
  • There is level 4 evidence that a specialised nurse-led community clinic provided up-to-date and readily applicable knowledge about bowel and bladder issues and skin breakdown, and was preferred over a medical clinic (Williams 2005).
  • There is level 3 evidence that depression rates are higher and onset is earlier among individuals with disabilities, especially traumatic-onset disabilities, such as SCI, compared to controls (McDermott et al, 2005).
  • There is level 5 evidence that 52% of contact with GP’s was regarding secondary complications; 34% of secondary complications are believed to be preventable; 72% report an unmet need for health care, particularly rehabilitation services (van Loo et al., 2009)
  • There is level 5 evidence that physiatrists consider bone health after SCI is an important issue, and favour treatment pharmacologically over rehabilitation (Ashe et al, 2009).
  • There is level 5 evidence that individuals with chronic SCI would like more information regarding aging with SCI, SCI research, and SCI educational information;  ethnic minorities had the greatest unmet needs for information (Gontkovsky et al, 2007).
  • There is level 5 evidence that 90% of individuals with SCI would like to receive written information about their condition following a medical checkup (Vaidyanathan et al, 2001).
  • There is level 5 evidence that 80% of issues raised by patients with SCI in primary care are disability-related; health promotion and counseling needs typically unmet (Warms, 1987).
  • There is level 5 evidence that needs for lifestyle and emotional issues often go unmet (Donnelly et al 2007).
  • There is level 5 evidence that the majority medical residents are not comfortable treating a women with tetraplegia who has recently become pregnant. (Oshima et al 1998)