The role of payment sources in the continuation of rehabilitation therapy in tertiary hospitals for patients with traumatic spinal cord injury: a study in Southwest China.

Medical security support for rehabilitation therapy in China is different from that in other countries. We investigated whether the discharge plan to continue rehabilitation therapy in tertiary hospitals for patients after traumatic spinal cord injury (TSCI) was influenced by payment sources or other conditions. This was a cross-sectional, observational study. Information was collected on the general condition, caregiver, types of payment sources for continued rehabilitation, American Spinal Injury Association Impairment Scale (AIS) scores, and discharge plans. In total, 135 patients with TSCI (107 male, mean age 41.00 ± 13.73 years, mean spinal cord injury duration 238.43 ± 345.54 days) were enrolled. Medical insurance (43%) and out-of-pocket payments (27.4%) were the primary payment sources. Although most patients were beyond the acute phase, 40% continued rehabilitation therapy at other tertiary hospitals. The caregiver, payment sources, injury level, AIS level, and complete urinary tract infection (UTI) were different due to discharge plans (p > .05). Patients seemingly consider a higher AIS level and co-UTI as the requirement for tertiary hospital therapy. In non-medical insurance payment source patients, the discharge plan also differed due to the AIS level and co-UTI (p > .05). However, in medical insurance patients, the discharge plan differed only in terms of TSCI duration (p > .05). The restricted duration of medical coverage restricted the continuation of rehabilitation therapy and influenced the discharge plan of most patients with TSCI.

The role of the sensory input intervention in recovery of the motor function in hypoxic ischemic encephalopathy rat model.

Motor disturbances predominantly characterize hypoxic-ischemic encephalopathy (HIE). Among its intervention methods, environmental enrichment (EE) is strictly considered a form of sensory intervention. However, limited research uses EE as a single sensory input intervention to validate outcomes postintervention. A Sprague-Dawley rat model subjected to left common carotid artery ligation and exposure to oxygen-hypoxic conditions is used in this study. EE was achieved by enhancing the recreational and stress-relief items within the cage, increasing the duration of sunlight, colorful items exposure, and introducing background music. JZL184 (JZL) was administered as neuroprotective drugs. EE was performed 21 days postoperatively and the rats were randomly assigned to the standard environment and EE groups, the two groups were redivided into control, JZL, and vehicle injection subgroups. The Western blotting and behavior test indicated that EE and JZL injections were efficacious in promoting cognitive function in rats following HIE. In addition, the motor function performance in the EE-alone intervention group and the JZL-alone group after HIE was significantly improved compared with the control group. The combined EE and JZL intervention group exhibited even more pronounced improvements in these performances. EE may enhance motor function through sensory input different from the direct neuroprotective effect of pharmacological treatment.NEW & NOTEWORTHY Rarely does literature assess motor function, even though it is common after hypoxia ischemic encephalopathy (HIE). Previously used environmental enrichment (EE) components have not been solely used as sensory inputs. Physical factors were minimized in our study to observe the effects of purely sensory inputs.

Current status of rehabilitation services and problems in Yunnan Province, Southwest China: a general doctors' questionnaire-based study.

OBJECTIVES: Community-based hospitals in China lack physicians, especially rehabilitation physicians. Recently, several financial resources have been developed to prepare general doctors for community-based hospitals. These doctors seem to be the best choices for assuming the role of a rehabilitation physician. However, their willingness and in-depth information from their perspectives have not been previously investigated. MATERIALS AND METHODS: We conducted a general investigation of rehabilitation resources in Yunnan, a province located in Southwest China with a population of more than 40 million. Our investigation covered the entire Yunnan Province from December 2020 to May 2022. The questionnaire was administered to 670 general doctors in 112 community hospitals randomly selected in Yunnan Province based on their willingness to assume the role of rehabilitation physicians and obstructive factors to process the rehabilitation services. The reliability and validity of the questionnaire were evaluated, and items regarding their general condition were analyzed. RESULTS: Cronbach's alpha and Kaiser-Meyer-Olkin values were 0.748 and 0.729, respectively. The measure comprises four factors: common disease, demand for training to improve skills, subjective/objective factors, and proactivity to recommend rehabilitation therapy. More than 20% of general doctors were unwilling to take on the role of rehabilitation physicians, and their willingness was related to satisfaction with their current job, comprehension of community-based rehabilitation, and comprehension of government support (p < .05). CONCLUSIONS: From the perspective of general doctors, the reimbursement rate for medical insurance, which burdens patients, is the greatest problem in the process of developing community-based hospital rehabilitation services. Offering professional training to increase their capacity and developing common practices to increase doctors' proactivity to recommend rehabilitation therapy may help increase the future support of medical insurance and increase general doctors' willingness to take on the role of a rehabilitation physician.