Figure 1.
Flow chart of the study design.
Starting with initial information acquisition, followed by process mapping (level 1 and 2), data collection & analyses, model development & validation and “what-if” scenario analyses.
Figure 2.
Summary of the variables estimated and the methodology involved in creating the simulation model.
All variables are significant (p-value<0.05). ✓Indicates the independent variable(s) that can estimate the dependent variable (e.g. the dependent variable AIS can be estimated by the independent variables age and energy); MOI: Mechanism of Injury; Neuro Level: Neurological Level of Injury; ISS: Injury Severity Score; GCS: Glasgow Coma Scale; AIS: ASIA Impairment Scale; SCU: Special Care Unit; VGH: Vancouver General Hospital; LOS: Length of Stay; ED: Emergency Department; OR: Operating Room; Rehab: Rehabilitation; FIM: Functional Independence Measure.
Table 1.
Ordinal logistic regression results for discharge AIS (number of observations = 489).
Figure 3.
Scenario One: Indirect impact of pressure ulcer reduction during acute care.
Reducing pressure ulcers during acute care has direct impacts on overall complications and length of stay in acute care, but also indirect impacts on rehabilitation complications, length of stay and bed utilization.
Figure 4.
Scenario Two: Indirect impacts of early surgery.
Providing early surgery to patients with tetraplegia has a direct impact on their neurological recovery and also indirect impact on their life expectancy, quality of life and savings in their rest of life costs.
Figure 5.
Scenario Three: The indirect impact of additional rehabilitation beds.
Adding rehabilitation beds has an impact on the admission to rehabilitation waiting time (alternative level of care days in acute), acute length of stay, bed utilization at the rehabilitation centre and rehabilitation length of stay. ALC: Alternative Level of Care Days; LOS: Length of Stay; Rehab: Rehabilitation.