Development and application of scoring systems supporting a successful rehabilitation and social reintegration of paraplegic patients

Status:

completed 12/2009

Aims:

The purpose of the study presented was to develop a score measuring the quality of outcome regarding inpatient treatment, rehabilitation and medical follow-up care in patients with spinal cord injuries. Basing upon the data collected we also intended to determine the status quo of the current rehabilitation procedures in the Spinal Cord Injury Centre of the BG Trauma Hospital Hamburg. Reintegration into working life and Community was intended to be studied in respect of lasting effects of the results achieved evaluating also detectable influencing factors for the future work of the medical facilities as well as the statutory accident insurance in the Federal Republic of Germany. Furthermore the study aimed at developing contents of follow-up care throughout the clinical sector.

Activities/Methods:

Basis for the study were the patients of the Spinal Cord Injury Centre in the BG Trauma Hospital Hamburg. Cooperating with the University of Hamburg, Department for research in rehabilitation and prevention, treatment data of 309 patients between 2005 and 2009 were collected. Data of 215 patients with the different predetermined points of measuring could be considered. For these participants time series existed, which in effect exceeded the usual duration of inpatient treatment and rehabilitation considerably. These additional data were collected by hospital or university staff either during follow-ups in hospital at predefined milestones or by face-to-face interviews.

Results:

The Boberg Quality Score (Bob Score) is available as a tool for patients with spinal cord injury for inpatient treatment, rehabilitation and follow-up care. It is suitable to demonstrate to which extent treatment and reintegration efforts were successful. The data base used is available for other additional research projects. The results of the study contribute to identify the quality and lasting effects of the results achieved. Along with the success of medical rehabilitation it was also possible to demonstrate the degree of success of reintegrating the patient into working and community life. Analyses over the whole duration of the study show, that the degree of reintegration targeted at is not reached.
The "Boberg Quality Score" (Bob Score) should be used as an assessment tool in the medical treatment of patients with spinal cord injuries throughout the entire clinical sector. A multicentre implementation study is planned to be supported by the trauma hospitals of the statutory accident insurance in order to introduce it.
The inadequate results of reintegration into working life are to be analyzed supported mutually by the DGUV (German Statutory Accident Insurance) and the accident insurances by means of a conceptually designed proceeding. The conclusions drawn should lead to adapted administrative proceedings and thus be able to achieve a significant improvement of the results.

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