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B - What Does the E-Scan Tell Us

Table 5.0 Number of Traumatic , Non-Traumatic and Total Admisions for Tetraplegia, by Level of Injury (n = 12). Level of Injury Traumatic Non- Traumatic Total % OF TOTAL Incomplete C1-4 91 69 160 53.2 Incomplete C5-8 57 26 83 27.6 Complete C1-4 23 4 27* 9.0 Complete C5-8 28 3 31 10.3 How Long do Individuals Stay in Rehabilitation? Across the 13 sites, length of stay (LOS) LOS ranges from 41 to 336 days, with an average of 103 days. The average service interruption is four days, ranging from 0 to 13 days, depending largely on the complexity of the injury and acquired secondary complications. Where do People Go after Rehabilitation? Forty-two percent of total SCI individuals (45% traumatic, 38% non-traumatic), from all 13 sites, went home, after discharge from rehabilitation. Although many of these individuals would also have received some type of outpatient rehabilitation, only 15% were reported to have some type of outpatient therapy. Surprising, is the number who transferred to some type of rehabilitation (n = 61) or long-term institutional care (n = 39). Clearly, as a rehabilitation community, we need to better understand the long-term rehabilitation needs, of these individuals. Table 6.0 shows the locations and number of transfers for traumatic and non-traumatic discharges, from SCI rehabilitation sites. What is the Cost of Rehabilitation? The total estimated budget, across 12 sites (one site did not provide this information), for the fiscal year 2009, was $43,161,435, with individual site budgets ranging from $107,398 to $12,555,416 (Figure 4.0). These data are too complex to interpret, as many of the sites are embedded in a larger hospital corporation, and have resources (funded by global budgets) that were not reported in the E-Scan data. Clearly, detailed economic studies must be conducted, to understand (at least on the inpatient level) the cost of rehabilitation, for individuals with SCI. A recent Ontario study of direct costs of health services, reports that the average, first-year, per-person cost of inpatient rehabilitation was $119,945, for traumatic SCI (2005/06).5 With the extensive resources required for SCI rehabilitation, it is essential that health utility analyses be conducted on the individual components of care across the continuum from acute care to community living, to ensure that resources are optimized for the best outcomes. Table 6.0 Locations and Number of Transfers, from SCI Rehabilitation Sites, for Traumatic and Non-Traumatic Discharges (n = 13). Trauma Non-Trauma Disposition Sector Location Number of Transfers Location Number of Transfers Home Home 160 Home 101 TOTAL (% of TOTAL) 160 (45.5%) 101 (38.5%) Acute Acute Care Hospitals 63 Acute Care Hospitals 74 Subacute Care 6 69 (19.6%) 74 (28.2%) Rehab Other Rehab Centre 34 Rehab Facility 24 Assisted Living Facility 3 Transitional Living - TOTAL (% of TOTAL) 34 (9.7%) 27 (10.3%) Institution Long-term Care Facility 12 Long-term Care 15 Acute and Continuing Care 5 Residential Care 3 Nursing Home 1 Extended Care 2 Continuing Care 1 TOTAL (% of TOTAL) 24 (6.8%) 15 (5.7%) Comunity Community Centre 26 Community Centre 18 Outpatient Care 5 Outpatient Care 4 Privacy Home Care 1 Private Practice 19 Private Practice 22 Agency 1 Outreach 1 TOTAL (% of TOTAL) 52 (14.8%) 45 (17.2%) Other Out-of-Province/ Regional Hospitals 11 Other (unspecified) 2 TOTAL (% of TOTAL) 13 (3.7%) 0 (0%) Total 352 262 WHAT DOES THE E-SCAN TELL US 41


B - What Does the E-Scan Tell Us
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