Indicators of Quality of Care in Individuals With Traumatic Spinal Cord Injury: A Scoping Review

Sepehr Khosravi, Amirmahdi Khayyamfar, Milad Shemshadi, Masoud Pourghahramani Koltapeh, Mohsen Sadeghi-Naini, Zahra Ghodsi, Farhad Shokraneh, Mohadeseh Sarbaz Bardsiri, Pegah Derakhshan, Khalil Komlakh, Alex R. Vaccaro, Michael G. Fehlings, James D. Guest, Vanessa Noonan, Vafa Rahimi-Movaghar

Research output: Contribution to journalReview articlepeer-review


Study Design: Scoping review. Objectives: To identify a practical and reproducible approach to organize Quality of Care Indicators (QoCI) in individuals with traumatic spinal cord injury (TSCI). Methods: A comprehensive literature review was conducted in the Cochrane Central Register of Controlled Trials (CENTRAL) (Date: May 2018), MEDLINE (1946 to May 2018), and EMBASE (1974 to May 2018). Two independent reviewers screened 6092 records and included 262 full texts, among which 60 studies were included for qualitative analysis. We included studies, with no language restriction, containing at least 1 quality of care indicator for individuals with traumatic spinal cord injury. Each potential indicator was evaluated in an online, focused group discussion to define its categorization (healthcare system structure, medical process, and individuals with Traumatic Spinal Cord Injury related outcomes), definition, survey options, and scale. Results: A total of 87 indicators were identified from 60 studies screened using our eligibility criteria. We defined each indicator. Out of 87 indicators, 37 appraised the healthcare system structure, 30 evaluated medical processes, and 20 included individuals with TSCI related outcomes. The healthcare system structure included the impact of the cost of hospitalization and rehabilitation, as well as staff and patient perception of treatment. The medical processes included targeting physical activities for improvement of health-related outcomes and complications. Changes in motor score, functional independence, and readmission rates were reported as individuals with TSCI-related outcomes indicators. Conclusion: Indicators of quality of care in the management of individuals with TSCI are important for health policy strategists to standardize healthcare assessment, for clinicians to improve care, and for data collection efforts including registries.

Original languageEnglish (US)
JournalGlobal Spine Journal
StateAccepted/In press - 2021


  • Iran
  • health care
  • health policy
  • quality indicators
  • quality of health care
  • registries
  • review
  • spinal cord injuries

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology


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