Hospitalizations of Patients With Spinal Cord Injury in Rural Australia: A Descriptive Study Over a 6-Year Period.

OBJECTIVES

To investigate (1) the number of hospital admissions, discharges, and transfers and (2) the principal diagnoses, length of stay (LOS), and mortality rates among patients with spinal cord injuries (SCIs) in rural Australia.

DESIGN

Descriptive study.

SETTING

Forty-one hospitals in Western New South Wales Local Health District (WNSWLHD), Australia.

PARTICIPANTS

Patients at least 18 years of age with SCI who have at least 1 hospital admission documented in electronic medical records within the rural WNSWLHD between 2014 and 2019.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Number and LOS of hospital admissions, discharges and transfers, principal diagnoses, and mortality outcomes.

RESULTS

One hundred and five patients, with an average age of 52±16 years, and the majority being male (83%), had 455 hospital admissions. Of 41 hospitals, 20 (49%) had at least 1 admission for patients with SCI. A total of 344 (76%) admissions were discharged home, whereas 32 (7%) admissions were transferred to metropolitan tertiary hospitals. Of the 105 patients, 49 (47%) were transferred to another New South Wales health facility at least once. A total of 4727 bed days (median [MD]=4.0, interquartile range [IQR]=1.0-10.0) were attributed to patients with SCI. Patients spent a median of 22 bed days (IQR=6.0-60.5) in hospital. Genitourinary conditions had the greatest number of admissions with a total of 156 admissions and 585 bed days (MD=1.0, IQR=1.0-4.0). Rehabilitation had the highest number of bed days, with 26 admissions and 901 bed days (MD=23.5, IQR=14.0-40.5). A total of 11 (10%) patients died during their admission.

CONCLUSION

Most rural patients with SCI residing within WNSWLHD were able to be managed locally for a broad range of medical and surgical care needs in a bespoke, pragmatic model of care.