Utilization and Access to Healthcare Services Among People Living with Spinal Cord Injuries in the

128 Pages·2016·1.1 MB·English

University of North Texas Health Science Center
UNTHSC Scholarly Repository
Teses and Dissertations
12-1-2014
Utilization and Access to Healthcare Services
Among People Living with Spinal Cord Injuries in
the Community
Shayan Noorani B.A.
University of North Texas Health Science Center at Fort Worth,
UTILIZATION AND ACCESS TO HEALTHCARE SERVICES AMONG PEOPLE
LIVING WITH SPINAL CORD INJURIES IN THE COMMUNITY
Shayan Noorani, B.A.
APPROVED:
__________________________________________________________
Major Professor
__________________________________________________________
Committee Member
__________________________________________________________
Committee Member
__________________________________________________________
Committee Member
__________________________________________________________
Department Chair
__________________________________________________________
Dean, Graduate School of Biomedical Sciences

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UTILIZATION AND ACCESS TO HEALTHCARE SERVICES AMONG PEOPLE
LIVING WITH SPINAL CORD INJURIES IN THE COMMUNITY

INTERNSHIP PRACTICUM REPORT
Presented to the Graduate Council of the
Graduate School of Biomedical Sciences
University of North Texas
Health Science Center at Forth Worth
In Partial Fulfillment of the Requirements

For the Degree of
MASTER OF SCIENCE IN CLINICAL RESEARCH MANAGEMENT

By
Shayan Noorani, B.A.
Fort Worth, Texas
November 2014

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ACKNOWLEDGMENTS

Dr. Simon Driver, PhD
Director of Research
Baylor Institute for Rehabilitation
Samantha Cleveland, BS
Research Assistant
Baylor Research Institute
TABLE OF CONTENTS

Page

SIGNATURE PAGE….………………………………………………………………….i
TITLE PAGE……………….…………………………………………………………….ii
ACKNOWLEDMENTS…………………………………………………………………iii
TABLE OF CONTENTS…………………………………………………………….......v
LIST OF TABLES……………………………………………………………………….vii
LIST OF ILLUSTRATIONS…………………………………………………………….ix
Chapter
I. INTRODUCTION ……………………………………………………………...1
II. INTERNSHIP SUBJECT………………………………………………………3
Background……………….……………………………………………….3
Specific Aims…………………………………………………………….13
Significance of the problem…...…………………………………............14
Research Design and Methodology…………………………………..….14
Results……………………………………………………………...…….18
Discussion………………………………………………………………..23
Conclusions………………………………………………………………28
Limitations……………………………………………………………….30
II. INTERNSHIP EXPERIENCE………………………………………………..32
General Internship Experience…………………………………………...32

APPENDIX…………………………………………………………………………..…..34
v
A. Daily Journal…………………………………………………………...…….34
B. Figures and Tables…………………………………………………………...86
C. Survey………………………………………………………………………..99
D. Table of Abbreviations……………………………………………………..108

REFERENCES…………………………………………………………………………109

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LIST OF TABLES
PAGE
Table 1: Summary of Demographic Characteristics…..………………………….10
Table 2: Summary of Spinal Cord Injury Information….………………………...11
Table 3: Doctor Visits in the Last 12 Months ...…………….…….......…….……87
Table 4: Accessibility of Doctor’s Offices and/or Equipment…….…..………….87
Table 5: Physician Knowledge and Communication……….…………………….89
Table 6: Emergency Room Visits…………….…………………...……………...92
Table 7: Preventative Care………………………...…….……………....………..92
Table 8: Summary of Demographic and Injury Related Characteristics for Patients
with an SCI/Rehab Visit vs. Patients without SCI/Rehab
Visits………………………………………………………………….…93
Table 9: Healthcare Utilization and Preventative Care for Patients with a
SCI/Rehab Visit vs. Patients without SCI/Rehab Visits…………………94
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Table 10: Summary of Demographic and Injury Related Characteristics for Patients
with an ER Visit vs. Patients without ER Visit in the Past 12
Months………………………………………………………………...…95
Table 11: Healthcare Utilization and Preventative Care for Patients with an ER Visit
vs. Patients without ER Visit in the Past 12
Months…………………………………………………………...………95

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LIST OF ILLUSTRATIONS
PAGE
Figure 1: Accessibility of Primary Care, SCI/Rehab, and Specialty Doctor’s
Office.………………...…………………………………...……………………………..89
Figure 2 (a-c): Physician Knowledge and Communication. ……………….…………...90

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