A path analysis of the healthcare utilization and services satisfaction among community-dwelling individuals with spinal cord injury in Malaysia

马来西亚社区居住脊髓损伤患者的医疗保健利用情况和服务满意度路径分析

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Abstract

PURPOSE: To explore healthcare utilization patterns and healthcare services satisfaction among individuals with spinal cord injury in Malaysia. METHODS: This cross-sectional study utilized the International Spinal Cord Injury (InSCI) Community Survey and involved 8 hospitals and 1 spinal cord injury organization. A total of 285 participants met the inclusion criteria. Subsequently, 6/11 sections of the InSCI questionnaire were analysed through a path analysis. RESULTS: The 3 most utilized healthcare providers reported were physical and rehabilitation medicine specialists (76.5%), physiotherapists (36.8%), and primary care physicians (27.4%). The top 3 most severe health problems reported were sexual dysfunction, muscle spasm and spasticity, and contractures. Healthcare services satisfaction was high. Health problems predicted healthcare utilization (β = 0.443), while activity limitation and participation restriction predicted healthcare services satisfaction (β = -0.202). The activity limitation and participation restriction in male participants was moderated by the spinal cord injury severity (B = 2.330, p  <  0.001) and health problems (B = 0.550, p < 0.001). CONCLUSIONS: Individuals with spinal cord injury in Malaysia rely heavily on physical and rehabilitation medicine specialists, highlighting accessibility challenges due to the centralized specialized rehabilitation services. Sexual dysfunction remains a significant yet under-addressed health concern. Despite these issues, satisfaction with healthcare services is high.

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