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Functioning and disability in people living with spinal cord injury in high- and low-resourced countries: a comparative analysis of 14 countries

Reinhardt, Jan ; Mansmann, Ulrich ; Fellinghauer, Bernd ; Strobl, Ralf ; Grill, Eva ; von Elm, Erik ; Stucki, Gerold

In: International Journal of Public Health, 2011, vol. 56, no. 3, p. 341-352

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    Titel
    • Functioning and disability in people living with spinal cord injury in high- and low-resourced countries: a comparative analysis of 14 countries
    Autor
    • Reinhardt, Jan. Swiss Paraplegic Research (SPF), 6207, Nottwil, Switzerland
    • Mansmann, Ulrich. Institute for Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilian University, Munich, Germany
    • Fellinghauer, Bernd. Swiss Paraplegic Research (SPF), 6207, Nottwil, Switzerland
    • Strobl, Ralf. Institute for Health and Rehabilitation Sciences, Ludwig-Maximilian University, Munich, Germany
    • Grill, Eva. Institute for Health and Rehabilitation Sciences, Ludwig-Maximilian University, Munich, Germany
    • von Elm, Erik. Swiss Paraplegic Research (SPF), 6207, Nottwil, Switzerland
    • Stucki, Gerold. Swiss Paraplegic Research (SPF), 6207, Nottwil, Switzerland
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • International Journal of Public Health, 2011, vol. 56, no. 3, p. 341-352. SP Birkhäuser Verlag Basel
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:314627
    Summary
    Objectives: We examined whether persons with spinal cord injury (SCI) from countries with differential resources and resource distribution differ in the level and structure of functioning and disability. Methods: We analysed cross-sectional data of 1,048 persons with SCI from 14 countries based on the International Classification of Functioning, Disability and Health (ICF). We used penalized logistic regression to identify ICF categories distinguishing lower- and higher-resourced countries. Hierarchical linear models were employed to predict the number of problems in functioning. The association structure of ICF categories was compared between higher- and lower-resourced countries using graphical models. Results: A total of 96 ICF categories separated lower- and higher-resourced countries. Differences were not univocal. Lower resources and unequal distribution were predictive of more functional problems in persons with higher age or tetraplegia. In the graphical models, few associations between ICF categories persisted across countries. Conclusion: Higher-resourced countries do not score higher in all ICF categories. Countries' economic resources and their distribution are significant predictors of disability in vulnerable groups such as tetraplegics and the elderly. Functioning is multi-dimensional and structures of association suggest that country-specific pathways towards disability exist