Abstract
Objective
To determine whether an evidence-based wellness program for individuals with spina
bifida and spinal cord injury would improve health outcomes and patient experience
of care, result in a positive return on investment (ROI), and provide evidence for
scalability.
Design
Nonrandomized, noncontrolled cohort study; 2 years of enrollment.
Setting
Academic hospital-based outpatient physiatry clinic partnered with an insurance division
within an integrated health care delivery and financing system.
Participants
Individuals (N=69) with spina bifida and spinal cord injury were consented; 4 were
excluded (5.7%), and the remaining 65 (94.2%) participated in the intervention.
Interventions
Evidence-based wellness program consisting of care coordination from a mobile nurse,
patient education, and patient incentives.
Main Outcome Measures
Validated measures of function, mood, quality of life, and perception of care delivery;
knowledge of preventable conditions; self-rating of health; and utilization and cost.
Results
Improvements in all main outcome measures were seen after 2 years of enrollment. Although
cost in year 1 of enrollment increased because of hospitalizations and the overall
ROI was negative, a small positive ROI was seen in year 2 of enrollment.
Conclusions
Participation in an evidence-based wellness program was associated with improved health
and experience of care. Scaling the program to larger numbers may result in an overall
positive ROI.
Keywords
List of abbreviations:
BDI-II (Beck Depression Inventory-II), CHART-SF (Craig Handicap Assessment and Reporting Technique-Short Form), ED (emergency department), PACIC (Patient Assessment of Chronic Illness Care), ROI (return on investment), SB (spina bifida), SCI (spinal cord injury), UTI (urinary tract infection), WHOQOL-BREF (World Health Organization Quality of Life-Brief Form)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 14, 2016
Footnotes
Supported by the University of Pittsburgh Medical Center (UPMC) Health Plan and the UPMC Rehabilitation Institute Pilot Grant.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
