# A PATH ANALYSIS OF THE HEALTHCARE UTILIZATION AND SERVICES SATISFACTION AMONG COMMUNITY-DWELLING INDIVIDUALS WITH SPINAL CORD INJURY IN MALAYSIA

## TL;DR

This study examines healthcare use and satisfaction among spinal cord injury patients in Malaysia, finding high reliance on rehabilitation specialists and high satisfaction despite significant health challenges.

## Contribution

The study identifies key healthcare utilization patterns and factors influencing satisfaction among spinal cord injury patients in Malaysia.

## Key findings

- Physical and rehabilitation medicine specialists are the most utilized healthcare providers.
- Sexual dysfunction is a significant but under-addressed health problem.
- Healthcare satisfaction is high despite challenges in accessibility.

## Abstract

To explore healthcare utilization patterns and healthcare services satisfaction among individuals with spinal cord injury in Malaysia.

This cross-sectional study utilized the International Spinal Cord Injury (InSCI) Community Survey and involved 8 hospitals and 1 spinal cord injury organization. A total of 285 participants met the inclusion criteria. Subsequently, 6/11 sections of the InSCI questionnaire were analysed through a path analysis.

The 3 most utilized healthcare providers reported were physical and rehabilitation medicine specialists (76.5%), physiotherapists (36.8%), and primary care physicians (27.4%). The top 3 most severe health problems reported were sexual dysfunction, muscle spasm and spasticity, and contractures. Healthcare services satisfaction was high. Health problems predicted healthcare utilization (β = 0.443), while activity limitation and participation restriction predicted healthcare services satisfaction (β = –0.202). The activity limitation and participation restriction in male participants was moderated by the spinal cord injury severity (B = 2.330, p < 0.001) and health problems (B = 0.550, p < 0.001).

Individuals with spinal cord injury in Malaysia rely heavily on physical and rehabilitation medicine specialists, highlighting accessibility challenges due to the centralized specialized rehabilitation services. Sexual dysfunction remains a significant yet under-addressed health concern. Despite these issues, satisfaction with healthcare services is high.

This study looked at how people with spinal cord injuries in Malaysia use healthcare services and how satisfied they are with these services. We surveyed 285 people from 8 hospitals and 1 spinal cord injuries organization across different parts of the country. The most common healthcare providers they visited were specialists in rehabilitation, physiotherapists, and primary care doctors. Participants said that sexual problems, muscle spasms, and stiffness were their most significant health issues. The study found that health problems affected how often people with spinal cord injuries used healthcare services, while their ability to do daily activities influenced their satisfaction. Overall, people with spinal cord injuries in Malaysia were quite satisfied with the healthcare services.