Health System’s Role in Facilitating Health Service Access among Persons with Spinal Cord Injury across 22 Countries

Int. J. Environ. Res. Public Health, 2023 · DOI: 10.3390/ijerph20116056 · Published: June 5, 2023

Spinal Cord Injury Healthcare Public Health

Simple Explanation

This study investigates how health systems in different countries affect access to healthcare services for people with spinal cord injuries (SCI). People with SCI often need regular, specialized care, but they face more obstacles in getting this care compared to the general population. The research analyzed data from over 12,000 individuals with SCI in 22 countries to identify common barriers to accessing services. It looked at factors like the number of healthcare workers, availability of infrastructure, and healthcare spending in each country. The study found that the country where a person lives is the biggest factor in whether they can access healthcare. Income and overall health status were also important, with those having lower incomes and poorer health facing more challenges.

Study Duration

2017-2019

Participants

12,588 participants with SCI across 22 countries

Evidence Level

Cross-sectional questionnaire survey

Key Findings

1
The country of residence was the most important factor in facilitating health service access.
2
Following the country of residence, higher income and better health were the most important facilitators of service access.
3
Health service availability and affordability were reported as the most frequent health access barriers.

Research Summary

This study examined the association between health system characteristics and access to health services among persons with SCI and to what extent this association is modiﬁed by socio-demographic and health status characteristics. We found that country of residence was the most important factor associated with access to health services. No health system characteristic related to access was identiﬁed. Following the country of residence, higher income and better health were the most important facilitators of service access. Health service availability and affordability were reported as the most frequent health access barriers.

Practical Implications

Policy Implications

Highlight the need for policy interventions tailored to specific country contexts to address systemic barriers to healthcare access for individuals with SCI.

Resource Allocation

Advocate for increased investment in healthcare infrastructure and workforce, especially in low- and middle-income countries, to improve service availability and affordability for vulnerable populations.

Healthcare Equity

Promote strategies to reduce income-related disparities in healthcare access and ensure that individuals with SCI receive comprehensive and equitable care, regardless of their socioeconomic status.

Study Limitations

1
The health system’s characteristics might not have been comprehensively measured, and the indicators may not have fully captured the impact of the health system.
2
Self-reported cross-sectional data were used, which might be subject to various biases, for example, recall bias and differences in medical and non-medical expectations from the health system.
3
The data collection methods differed among participating countries, which could have led to a difference in data quality.

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