Greg Vigna, MD, JD: Spinal Cord Injury Rehab Should Be Based On Goals
03/13/2013 // Concord, CA, USA // LifeCare123 // Greg A. Vigna // (press release)
‘There are approximately 12,000 new spinal cord injury cases each year. Since the 1970s there has been a significant decrease in the average length of stay for these patients during their acute rehabilitation, decreasing from 98 days to 37 days. This is despite the fact that during this time the average age has increased from 29 years of age to 41′. One would think that with an increase in average age of a patient there would be an increase in length of stay because of age related development of medical co-morbidites such as diabetes, coronary artery disease, and osteoarthritis. Today there is ‘increased attention on length of stay by payor sources such as private insurance and government agencies since it is viewed as an indicator of effectiveness of health care delivery since a shorter length of stay is believed to be the result from effective management, reduced medical complications, and increased expertise of an organization. Length of stay of an individual patient is complex and is dependent on multiple factors including level of injury, medical comorbidities, health care practices, insurance, reimbursement pattern, social, psychological, financial and the discharge destination,’ reports Concord Personal Injury Lawyer Greg Vigna.
It is this author’s opinion that the decrease in length of stay can be partly explained by improved clinical practices of the model spinal cord injury centers and the improved coordination of services available in these centers. This is supported by studies that show similar function gains at discharge despite the decreased length of stay when comparing patients with similar levels of injury.
It is this author’s opinion that the decrease in length of stay can be partly explained by factors that have nothing to do with the individual complexities of a patient who has suffered a spinal cord injury. Arbitrary decisions by insurance payers regarding discharge date and discharge disposition are increasingly influencing the care of these unfortunate patients. Spinal cord injured patients require a coordinated multidisciplinary approach to care which includes psychological counseling, family counseling, patient and family education, coordinated physical and occupational therapy, sexual counseling, under the care of a physiatrist who is trained in the management of these patients. These medical professionals on admission will determine both short term and long term goals that should be attained and put together a treatment plan that will enable the patient to attain these goals. Length of stay should be determined by the attainment of these functional goals and attainment of educational goals and not on arbitrary decisions by payer sources. This level of care is simply not possible in a nursing home and needs to be done in an acute rehabilitation hospital to obtain maximum functional outcome and to educate the patient to prevent future medical complications.
Life Care Planner Perspective:
An individual who has suffered a spinal cord injury will have significant lifelong medical and rehabilitation needs which will change as the individual ages. It is a life care planner’s role to provide a road map for the care of these patients to maximize function, reduce or eliminate complications, and improve the individual’s quality of life going forward. All recommendations must be medically necessary and must be appropriate.
Based on my training and my experience of caring for patients who have suffered a spinal cord injury it is my opinion that acute rehabilitation of a spinal cord injured patient should be at a qualified center of excellence for spinal cord injury. These facilities have unique experience in the management of these patients. They provide for a multidisciplinary approach to the management of these patients that will improve outcomes and prevent future complications. They provide for a safe and appropriate discharge disposition based on the individual needs of the patient with plans of future care and follow up that is both medically necessary and appropriate.
Damages in a Spinal Cord injury have been some of the most significant awards reflecting the economic and noneconomic impact of this injury. Several factors are the driving factors, including the permanence of injury and the needs for future care report the Concord Personal Injury Lawyer. Past and future economic (lost wages, medical expenses, medical care) and past and future noneconomic damages (pain and suffering) need to carefully mapped out by a qualified team of litigators who specialize in spinal cord injuries. Future medical needs can be a major component because a person who suffers a spine cord injury caused by the negligence, carelessness (negligence) or wrongdoing of another has a right to recover for everything that has a reasonable rehabilitative probability. A life care planner and medical specialist trained in the management of the care with spinal cord injuries will be need to provide the medical foundation to prove these damages in the future. It is essential that a patient receive the best care possible to prevent these unlikely future complications; they will not be compensated for if anything that occurs after the judgment or settlement. A center of excellence for spinal cord injury and a well-designed life care plan will provide for the medically necessary and appropriate care to prevent these complications.
Greg A. Vigna
Concord Personal Injury Lawyer
Address: 1401 Willow Pass Road, Concord, CA 94520
Url: Lifecare Solutions Group
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