Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 10 , Pages 1941-1947 , October 2008

Issues and Challenges for Development of a Sustainable Service Model for People With Spinal Cord Injury Living in Rural Regions

Presented in part to the Australian and New Zealand Spinal Cord Society Conference, November 1–3, 2007, Sydney, Australia.

  • James W. Middleton, MBBS, PhD

      Affiliations

    • Rehabilitation Studies Unit, Faculty of Medicine, University of Sydney, Sydney, Australia
    • New South Wales Spinal Outreach Service, Sydney, Australia
    • New South Wales State Spinal Cord Injury Service, Sydney, Australia
    • Corresponding Author InformationCorrespondence to James W. Middleton, MBBS, PhD, Rehabilitation Studies Unit, Faculty of Medicine, University of Sydney, PO Box 6, Ryde NSW 1680, Australia
    • ,
  • Melissa McCormick, RN, BaHSc, MPH

      Affiliations

    • New South Wales Spinal Outreach Service, Sydney, Australia
    • ,
  • Stella Engel, MBBS

      Affiliations

    • Spinal and Rehabilitation Medicine Department, Prince of Wales Hospital, Sydney, Australia
    • ,
  • Susan B. Rutkowski, MBBS, MHA

      Affiliations

    • Spinal Cord Injury Outpatient Services and Research, Royal North Shore Hospital, Sydney, Australia
    • ,
  • Ian D. Cameron, MBBS, PhD

      Affiliations

    • Rehabilitation Studies Unit, Faculty of Medicine, University of Sydney, Sydney, Australia
    • ,
  • Peter Harradine, MBBS

      Affiliations

    • Rehabilitation Unit, Tamworth Base Hospital, Tamworth, NSW, Australia
    • ,
  • Jennifer L. Johnson, BAppSci, MHA

      Affiliations

    • New South Wales Spinal Outreach Service, Sydney, Australia
    • New South Wales State Spinal Cord Injury Service, Sydney, Australia
    • ,
  • David Andrews, RN, GradCertHSM

      Affiliations

    • New South Wales State Spinal Cord Injury Service, Sydney, Australia

References 

  1. Rummery E, Bowles M. The report of the Rural Health Implementation Coordination Group (Government Action Plan). Sydney: NSW Department of Health; 2002;
  2. Australian Institute of Health and Welfare. Australia's health 2006. Canberra: AIHW; 2006;AIHW Cat No. Aus 73
  3. Hagglund KJ, Clay DL, Acuff M. Community reintegration for persons with spinal cord injury living in rural America. Top Spinal Cord Inj Rehabil. 1998;4:28–40
  4. Booth S, Kendall M. Benefits and challenges of providing transitional rehabilitation services to people with spinal cord injury from regional, rural and remote locations. Aust J Rural Health. 2007;15:172–178
  5. Cox RJ, Amsters DI, Pershouse KJ. The need for a multidisciplinary outreach service for people with spinal cord injury living in the community. Clin Rehabil. 2001;15:600–606
  6. Moulton PL, Miller ME, Offutt SM, Gibbens BP. Identifying rural health care needs using community conversations. J Rural Health. 2007;32:92–96
  7. Anson C, Shepard C. Incidence of secondary complications in spinal cord injury. Int J Rehabil Res. 1996;19:55–66
  8. Johnston RL, Gerhart KA, McCray J, Menconi JC, Whiteneck GG. Secondary conditions following spinal cord injury in a population-based sample. Spinal Cord. 1998;36:45–50
  9. Savic G, Short DJ, Weitzenkamp D, Charlifue S, Gardner BP. Hospital readmissions in people with chronic spinal cord injury. Spinal Cord. 2000;38:371–377
  10. Klotz R, Joseph PA, Ravaud JF, Wiart L, Barat M Tetrafigap Group. The Tetrafigap survey on the long-term outcome of tetraplegic spinal cord injured persons: part III (Medical complications and associated factors). Spinal Cord. 2002;40:457–467
  11. Middleton JW, Lim K, Taylor L, Soden R, Rutkowski S. Patterns of morbidity and rehospitalisation following spinal cord injury. Spinal Cord. 2004;42:359–367
  12. Krause JS. Skin sores after spinal cord injury: relationship to life adjustment. Spinal Cord. 1998;36:51–56
  13. Meyers AR, Mitra M, Klein Walker D, Wilber N, Allen D. Predictors of secondary conditions in a sample of independently living adults with high-level spinal cord injury. Top Spinal Cord Inj Rehabil. 2000;6:1–8
  14. Australian Institute of Health and Welfare. Health in rural and remote Australia. Canberra: AIHW; 1998;AIHW Cat No. PHE 6
  15. Seekins T, Clay J, Ravesloot C. A descriptive study of secondary conditions reported by a population of adults with physical disabilities served by three independent living centres in a rural state. J Rehabil. 1994;60:47–51
  16. Humphreys JS, Wakerman J, Wells R. What do we mean by sustainable rural health services? (Implications for rural health research). Aust J Rural Health. 2006;14:33–35
  17. Gruen RL, Weeramanthri TS, Knight SE, Bailie RS. Specialist outreach clinics in primary care and rural hospital settings. Cochrane Database Syst Rev. 2004;(1):CD003798
  18. Mann L, Middleton JW, Leong G. Fitting disability into practice: focus on spinal cord injury. Aust Fam Physician. 2007;36:1039–1042
  19. Donnelly C, McColl MA, Charlifue S, et al. Utilization, access and satisfaction with primary care among people with spinal cord injuries: a comparison of three countries. Spinal Cord. 2007;54:25–36
  20. Battye KM, McTaggart K. Development of a model of sustainable delivery of outreach allied health services to remote north-west Queensland, Australia. Rural Remote Health. 2003;3:194
  21. Hauber RP, Jones ML, Temkin AJ, Vesmarovich S, Phillips VL. Extending the continuum of care after spinal cord injury through telerehabilitation. Top Spinal Cord Inj Rehabil. 1999;5:11–20
  22. Galea M, Tumminia J, Garback LM. Telerehabilitation in spinal cord injury persons: a novel approach. Telemed J E Health. 2006;12:160–162
  23. Schopp LH, Kirkpatrick HA, Hagglund KJ, Meyer TM, Meyer L. Serving rural women with spinal cord injury: training needs assessment of health professionals in rural settings. Psychosoc Process. 1999;14:132–139

 Supported by the Motor Accidents Authority of New South Wales, the Commonwealth Government through the Medical Specialist Outreach Assistance Program (travel support), the Paraplegic and Quadriplegic Association of New South Wales (travel and accommodation costs), the Australian Quadriplegic Association (now Spinal Cord Injuries Australia), and the New South Wales Spinal Outreach Service.

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

 Reprints are not available from the author.

PII: S0003-9993(08)00500-5

doi: 10.1016/j.apmr.2008.04.011

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 10 , Pages 1941-1947 , October 2008

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