Mamin FA1, Hayes R1, Hassan N1, Hossain M2, Ahmed S1, Helal SU3
1Bangladesh Health Professions Institute (BHPI), Physiotherapy, Savar, Dhaka, Bangladesh, 2Centre for the Rehabilitation of the Paralysed (CRP), Physiotherapy, Savar, Dhaka, Bangladesh, 3Centre for the Rehabilitation of the Paralysed (CRP), Medical Services, Savar, Dhaka, Bangladesh
Background: Timely and appropriate care plays an integral role to patient health and functional outcomes following a traumatic spinal cord injury (SCI). The health care system in Bangladesh is underdeveloped and fragmented, with no existing care pathway established for SCI. As a result, the care of patients with SCI is convoluted and experiences great variance from patient to patient. With little or no national health statistics available, there is no record of the healthcare pathways that these patients currently follow. In order for a SCI care pathway to be developed or improved, data needs to be gathered on the existing management from presentation of injury.
Purpose: The aim of this study was to explore the patient journeys through the healthcare system following a traumatic SCI in Bangladesh.
Methods: We carried out a questionnaire among the traumatic SCI patients admitted at Centre for the Rehabilitation of Paralysed (CRP), Savar, Dhaka, Bangladesh between July 2017 and June 2018. This is the only SCI rehabilitation centre in Bangladesh. We recorded the patient journey from injury onset to their admission to the rehabilitation centre.
Results: A total 125 patients were included in this study (90% were male). Only 20% patients received some form of first aid immediately following injury, of which only 50% was provided by registered physicians. All patients were admitted to hospital. Transport from site of injury to hospital was provided by ambulance (41%), Easy bike (29%), rickshaw (27%), and motorbike (3%). In 98% of cases, there was no attempt made to immobilize the spine during transfers. 52% were X-rayed at the first health care facility and of these only 27% received a correct diagnoses of SCI.
Only 21% patients were informed about their prognosis after SCI was confirmed. About 33% patients were discharged directly home from acute care hospital without any rehabilitation. About 60% of patients were referred for rehabilitation by physicians or other health professionals and 40% patients attended rehabilitation following recommendations from friends/family.
Only 19% patients were referred directly for rehabilitation from their first hospital. 34% patients attended 2 hospitals, 23% attended 3 and 5% patients traveled to 7 hospitals before being admitted to a specialized spinal cord injury hospital (CRP).
Conclusion(s): There is no established pathway for patients with spinal cord injury in Bangladesh. Knowledge and guidelines regarding rehabilitation for this type of injury is also significantly lacking.
Implications: Care system of SCI must need to be systematic and accessible to sufferers.
Keywords: Spinal Cord Injury, Health care
Funding acknowledgements: No funding received
Purpose: The aim of this study was to explore the patient journeys through the healthcare system following a traumatic SCI in Bangladesh.
Methods: We carried out a questionnaire among the traumatic SCI patients admitted at Centre for the Rehabilitation of Paralysed (CRP), Savar, Dhaka, Bangladesh between July 2017 and June 2018. This is the only SCI rehabilitation centre in Bangladesh. We recorded the patient journey from injury onset to their admission to the rehabilitation centre.
Results: A total 125 patients were included in this study (90% were male). Only 20% patients received some form of first aid immediately following injury, of which only 50% was provided by registered physicians. All patients were admitted to hospital. Transport from site of injury to hospital was provided by ambulance (41%), Easy bike (29%), rickshaw (27%), and motorbike (3%). In 98% of cases, there was no attempt made to immobilize the spine during transfers. 52% were X-rayed at the first health care facility and of these only 27% received a correct diagnoses of SCI.
Only 21% patients were informed about their prognosis after SCI was confirmed. About 33% patients were discharged directly home from acute care hospital without any rehabilitation. About 60% of patients were referred for rehabilitation by physicians or other health professionals and 40% patients attended rehabilitation following recommendations from friends/family.
Only 19% patients were referred directly for rehabilitation from their first hospital. 34% patients attended 2 hospitals, 23% attended 3 and 5% patients traveled to 7 hospitals before being admitted to a specialized spinal cord injury hospital (CRP).
Conclusion(s): There is no established pathway for patients with spinal cord injury in Bangladesh. Knowledge and guidelines regarding rehabilitation for this type of injury is also significantly lacking.
Implications: Care system of SCI must need to be systematic and accessible to sufferers.
Keywords: Spinal Cord Injury, Health care
Funding acknowledgements: No funding received
Topic: Neurology: spinal cord injury; Globalisation: health systems, policies & strategies
Ethics approval required: Yes
Institution: Bangladesh Health Professions Institute(BHPI), the academic institute of CRP
Ethics committee: The Institutional Review Board (IRB)
Ethics number: CRP-BHPI/IRB/09/18/1223
All authors, affiliations and abstracts have been published as submitted.
