October 2024 CME Activity: Association Between Health Service Systems and Pressure Injury Problems of Individuals With Chronic Spinal Cord Injury in Malaysia, Indonesia, and Thailand: A Cross-sectional Study-Association Between Health Service Systems and Pressure Injury Problems of Individuals With Chronic Spinal Cord Injury in Malaysia, Indonesia, and Thailand: A Cross-sectional Study

Association Between Health Service Systems and Pressure Injury Problems of Individuals With Chronic Spinal Cord Injury in Malaysia, Indonesia, and Thailand: A Cross-sectional Study

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Pdf Summary

A cross-sectional study examined whether health service systems affect the prevalence of pressure injuries (PIs) in individuals with chronic spinal cord injuries (SCI) in Malaysia, Indonesia, and Thailand. The study utilized data from the International Spinal Cord Injury Community Survey, categorizing health service systems into inpatient-oriented SCI-specialized systems and primary care-oriented systems.<br /><br />The analysis included 790 participants, revealing that 35% had PI issues. Key findings indicate that participants from countries with inpatient-oriented SCI-specialized systems (Malaysia and Thailand) were less likely to have PI problems compared to those from a primary care-oriented system (Indonesia). This was supported by logistic regression models showing that being in an inpatient-oriented system was significantly associated with a lower likelihood of PI issues, with odds ratios of 0.569 and 0.591, respectively.<br /><br />The study emphasized the protective role of SCI-specialized health services against PI problems, suggesting the importance of such services in middle-income countries to reduce PI prevalence. It recommends the establishment and encouragement of SCI-specialized facilities and medical education in these regions to improve patient outcomes. Despite some limitations, such as potential selection bias and the use of self-reported data, the findings underline the critical impact of specialized healthcare systems on managing secondary health conditions in individuals with SCI.

Keywords

cross-sectional study

health service systems

pressure injuries

spinal cord injuries

Malaysia

Indonesia

Thailand

inpatient-oriented systems

primary care-oriented systems

SCI-specialized facilities