Development and Validation of a Medical Home Model for Persons with Spinal Cord Injuries

Background: Access to primary care is vital for any patient. For patients with disabilities, particularly with spinal cord injuries, primary care is difficult to find. Most primary care providers do not have physically accessible clinics, nor do they have a provider knowledgeable of spinal cord injury care. With little to no access to a primary care provider, most individuals with spinal cord injuries will typically turn to rehabilitation centers and clinics for their healthcare needs. These clinics are generally equipped to handle the specialty care needs of these individuals, such as bowel and bladder care, neuropathic pain, spasticity, and other physical-related issues. However, these centers typically do not provide primary care services; the focus is strictly on the specialty care needs of this population.

Purpose: The purpose of this project is to develop a model of care that integrates primary care into specialty care clinics for patients with spinal cord injuries, specifically at Rancho Los Amigos National Rehabilitation Center’s Outpatient Center.

Methods: A review of evidence-based literature was completed on the healthcare needs of the spinal cord injury population, including a review of models of care to integrate primary care into specialty care. The Donabedian framework was used to guide the spinal cord injury medical home model using three components: structure, process, outcomes (Donabedian, 1966). This model will be validated by a panel of experts knowledgeable on spinal cord injury and primary care.

Results: The content of the model is organized by Donabedian’s structure, process, and outcomes framework. The model includes the relevance and importance on key components of care including physical space requirements, equipment needs, personnel, coordination, referral management, and healthcare outcomes.

Conclusion/implications: This model has the potential to improve overall access to care, improve care coordination, and improve patient outcomes. The next step will be to implement and evaluate the model. Once implemented and evaluated, the model of care can be further replicated at other outpatient spinal cord injury specialty care centers due to its scalability.
Note: This poster featured in virtual display only.