Effectiveness of a WellnessProgram for Individuals with Spina Bifida and Spinal Cord Injuries within an Integrated Delivery System

Publication date: Available online 14 June 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Brad E. Dicianno, John Lovelace, Pamela Peele, Christopher Fassinger, Patricia Houck, Alexandra Bursic, Michael L. Boninger
ObjectiveTo determine whether an evidence-based wellness program for individuals with spina bifida (SB) and spinal cord injury (SCI) would improve health outcomes and patient experience of care, result in a positive return on investment (ROI), and provide evidence for scalability.Design: non-randomized, non-controlled cohort study; two years of enrollmentSettingAcademic hospital-based outpatient physiatry clinic partnered with an insurance division within an integrated healthcare delivery and financing systemParticipantsSixty nine individuals with SB and SCI were consented, 4 were excluded, and the remaining 65 participated in the intervention.Interventionevidence-based wellness program consisting of care coordination from a mobile nurse, patient education, and patient incentives.Main Outcome Measure(s)validated measures of function, mood, quality of life, and perception of care delivery; knowledge of preventable conditions; self-rating of health; utilization and cost.Resultsimprovements in all main outcome measures were seen after two years of enrollment. Although cost in year 1 of enrollment increased due to hospitalizations, and the overall ROI was negative, a small positive ROI was seen in year 2 of enrollment.Conclusionsparticipation in an evidence-based wellness program was associated with improved health and experience of care. Scaling the program to larger numbers may result in an overall positive ROI.



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