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  4. Association of Race, Socioeconomic Status, and Health Care Access with Pressure Ulcers after Spinal Cord Injury

Association of Race, Socioeconomic Status, and Health Care Access with Pressure Ulcers after Spinal Cord Injury

Arch Phys Med Rehabil, 2012 · DOI: 10.1016/j.apmr.2012.02.004 · Published: June 1, 2012

Spinal Cord InjuryHealthcarePublic Health

Simple Explanation

This study looked at how race and socioeconomic status (SES) relate to pressure ulcers (PUs) in people with spinal cord injury (SCI), considering their access to health care. The study found that lower income was linked to higher chances of having pressure ulcers, even when considering health care access. However, the initial link between race and pressure ulcers disappeared after considering income and health care access. Access to healthcare had mixed effects; having a personal doctor was linked to more past surgeries for pressure ulcers, while not being able to afford medical care was linked to having current pressure ulcers or reduced sitting time due to pressure ulcers.

Study Duration
Not specified
Participants
2,549 persons with traumatic SCI
Evidence Level
Cross-sectional study

Key Findings

  • 1
    Household income was significantly associated with PU outcomes after controlling for demographic and injury factors and remained significant after accounting for the HCA factors.
  • 2
    Persons with lower income had higher odds of each PU outcome.
  • 3
    HCA was related to PU outcomes in 2 different ways.

Research Summary

This study assessed the relationships of socioeconomic status (SES) and health care access (HCA) with pressure ulcer (PU) outcomes among individuals with spinal cord injury (SCI). The study found that lower income was consistently associated with increased odds of PU, current PU, reduced sitting time and PU surgery. The study concludes that healthcare providers should be aware of the increased risk of PU outcomes in lower SES populations, even after accounting for basic HCA factors such as insurance.

Practical Implications

Targeted Interventions

Healthcare providers should focus on lower socioeconomic status (SES) populations with SCI to prevent pressure ulcers.

Address Healthcare Access

Address financial barriers to healthcare to improve pressure ulcer outcomes.

Further Research

Future studies should include a broader assessment of HCA factors and should use longitudinal data to assess the recurrence of PU outcomes among individuals with SCI.

Study Limitations

  • 1
    Reliance on self-report data from mail-in surveys.
  • 2
    Inability to assess the severity or grade of pressure ulcers.
  • 3
    Cross-sectional design limits establishing the sequence of events.

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