{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T05:14:53Z","timestamp":1778303693452,"version":"3.51.4"},"reference-count":21,"publisher":"BMJ","issue":"11","funder":[{"name":"iCare - Lifetime care and Support"},{"name":"Ramsay Research & Teaching Fund"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,9,26]]},"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Traumatic spinal cord injuries have significant consequences both for the injured individual and the healthcare system, usually resulting in lifelong disability. Evidence has shown that timely medical and surgical interventions can lead to better patient outcomes with implicit cost savings. Potentially preventable secondary complications are therefore indicators of the effectiveness of acute care following traumatic injury. The extent to which policy and clinical variation within the healthcare service impact on outcomes and acute care costs for patients with traumatic spinal cord injury (TSCI) in Australia is not well described.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>A comprehensive data set will be formed using record linkage to combine patient health and administrative records from seven minimum data collections (including costs), with an existing data set of patients with acute TSCI (Access to Care Study), for the time period June 2013 to June 2016. This person-level data set will be analysed to estimate the acute care treatment costs of TSCI in New South Wales, extrapolated nationally. Subgroup analyses will describe the associated costs of secondary complications and regression analysis will identify drivers of higher treatment costs. Mapping patient care and health service pathways of these patients will enable measurement of deviations from best practice care standards and cost-effectiveness analyses of the different pathways.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>Ethics approval has been obtained from the New South Wales Population and Health Services Research Ethics Committee. Dissemination strategies include peer-reviewed publications in scientific journals and conference presentations to enable translation of study findings to clinical and policy audiences.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-023785","type":"journal-article","created":{"date-parts":[[2018,11,8]],"date-time":"2018-11-08T23:19:44Z","timestamp":1541719184000},"page":"e023785","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Assessing the impact of care pathways on potentially preventable complications and costs for spinal trauma patients: protocol for a data linkage study using cohort study and administrative data"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1060-4380","authenticated-orcid":false,"given":"Bharat Phani","family":"Vaikuntam","sequence":"first","affiliation":[{"name":"Sydney Medical School - Northern, University of Sydney, Sydney, New South Wales, Australia"},{"name":"Kolling Institute, John Walsh Centre for Rehabilitation Research, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James W","family":"Middleton","sequence":"additional","affiliation":[{"name":"Sydney Medical School - Northern, University of Sydney, Sydney, New South Wales, Australia"},{"name":"Kolling Institute, John Walsh Centre for Rehabilitation Research, Sydney, New South Wales, Australia"},{"name":"Agency for Clinical Innovation, NSW Statewide Spinal Cord Injury Service, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"McElduff","sequence":"additional","affiliation":[{"name":"Health Policy Analysis, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jim","family":"Pearse","sequence":"additional","affiliation":[{"name":"Health Policy Analysis, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Walsh","sequence":"additional","affiliation":[{"name":"Sydney Medical School - Northern, University of Sydney, Sydney, New South Wales, Australia"},{"name":"Kolling Institute, John Walsh Centre for Rehabilitation Research, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian D","family":"Cameron","sequence":"additional","affiliation":[{"name":"Kolling Institute, John Walsh Centre for Rehabilitation Research, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8977-6144","authenticated-orcid":false,"given":"Lisa Nicole","family":"Sharwood","sequence":"additional","affiliation":[{"name":"Sydney Medical School - Northern, University of Sydney, Sydney, New South Wales, Australia"},{"name":"Kolling Institute, John Walsh Centre for Rehabilitation Research, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,11,8]]},"reference":[{"key":"2025101814281139000_8.11.e023785.1","unstructured":"Access Economics. The economic cost of spinal cord injury and traumatic brain injury in Australia. Access Economics for the Victorian Neurotrauma Initiative. Canberra, 2009."},{"key":"2025101814281139000_8.11.e023785.2","unstructured":"Australian Bureau of Statistics. Consumer Price Index. Canberra: Australian Bureau of Statistics, 2017."},{"key":"2025101814281139000_8.11.e023785.3","unstructured":"Norton L . Spinal Cord Injury, Australia, 2007-08. Canberra: Australian Institute of Health and Welfare, 2010."},{"key":"2025101814281139000_8.11.e023785.4","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1097\/SLA.0000000000000873","article-title":"Increased trauma center volume is associated with improved survival after severe injury: results of a Resuscitation Outcomes Consortium study","volume":"260","author":"Minei","year":"2014","journal-title":"Ann Surg"},{"key":"2025101814281139000_8.11.e023785.5","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.apmr.2014.08.013","article-title":"Estimating the incidence and prevalence of traumatic spinal cord injury in Australia","volume":"96","author":"New","year":"2015","journal-title":"Arch Phys Med Rehabil"},{"key":"2025101814281139000_8.11.e023785.6","unstructured":"Spinal Cord Injuries Australia. SCI Statistics. NSW: SCIA, 2017."},{"key":"2025101814281139000_8.11.e023785.7","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1186\/s12913-014-0600-7","article-title":"Right care, right time, right place: improving outcomes for people with spinal cord injury through early access to intervention and improved access to specialised care: study protocol","volume":"14","author":"Middleton","year":"2014","journal-title":"BMC Health Serv Res"},{"key":"2025101814281139000_8.11.e023785.8","doi-asserted-by":"crossref","DOI":"10.1038\/sc.2012.81","article-title":"Direct costs of adult traumatic spinal cord injury in Ontario","volume":"51","author":"Munce","year":"2013","journal-title":"Spinal Cord"},{"key":"2025101814281139000_8.11.e023785.9","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3100501"},{"key":"2025101814281139000_8.11.e023785.10","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/j.injury.2011.12.010","article-title":"The pre-hospital epidemiology and management of spinal cord injuries in New South Wales: 2004-2008","volume":"43","author":"Middleton","year":"2012","journal-title":"Injury"},{"key":"2025101814281139000_8.11.e023785.11","doi-asserted-by":"crossref","first-page":"2816","DOI":"10.1089\/neu.2012.2503","article-title":"Does timing of surgery affect hospitalization costs and length of stay for acute care following a traumatic spinal cord injury?","volume":"29","author":"Mac-Thiong","year":"2012","journal-title":"J Neurotrauma"},{"key":"2025101814281139000_8.11.e023785.12","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1055\/s-0035-1564052","article-title":"Timing of Surgery for Neurologically Compromised Traumatic Cervical Spine Injuries","volume":"77","author":"Rackauskas","year":"2016","journal-title":"J Neurol Surg A Cent Eur Neurosurg"},{"key":"2025101814281139000_8.11.e023785.13","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0032037","article-title":"Early versus delayed decompression for traumatic cervical spinal cord injury: results of the Surgical Timing in Acute Spinal Cord Injury Study (STASCIS)","volume":"7","author":"Fehlings","year":"2012","journal-title":"PLoS One"},{"key":"2025101814281139000_8.11.e023785.14","first-page":"20","article-title":"Modelling the direct health care costs of chronic wounds in Australia","volume":"22","author":"Graves","year":"2014","journal-title":"Wound Practice & Research: Journal of the Australian Wound Management Association"},{"key":"2025101814281139000_8.11.e023785.15","unstructured":"Australian Government. Biennial health report of the Australian Institute of Health and Welfare. Canberra: Australia\u2019s Health, 2014."},{"key":"2025101814281139000_8.11.e023785.16","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1071\/AH13061","article-title":"Major trauma: the unseen financial burden to trauma centres, a descriptive multicentre analysis","volume":"38","author":"Curtis","year":"2014","journal-title":"Aust Health Rev"},{"key":"2025101814281139000_8.11.e023785.17","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101601"},{"key":"2025101814281139000_8.11.e023785.18","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-012377","article-title":"Improving care standards for patients with spinal trauma combining a modified e-Delphi process and stakeholder interviews: a study protocol","volume":"7","author":"Sharwood","year":"2017","journal-title":"BMJ Open"},{"key":"2025101814281139000_8.11.e023785.19","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200017050-00007"},{"key":"2025101814281139000_8.11.e023785.20","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d1548"},{"key":"2025101814281139000_8.11.e023785.21","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-7-50"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2018-023785","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T21:28:18Z","timestamp":1760822898000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2018-023785"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11]]},"references-count":21,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2018,11,8]]},"published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1136\/bmjopen-2018-023785"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2018-023785","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11]]}}}