Improving quality of care in traumatic spinal column/spinal cord injuries (TSC/SCI) in Iran: a policy brief

Study design: Descriptive study.

Objectives: The National Spinal Cord/Column Injury Registry of Iran (NSCIR-IR) is a registry system to survey Traumatic Spinal Column/Spinal Cord Injuries (TSC/SCIs) patients and obtain the required data for quality-of-care assessment.

Setting: Iran.

Methods: In 2022, the pre-hospital, in-hospital, and post-hospital Quality of Care (QoC) of registered patients with TSC/SCIs in 8 referral hospitals in Iran were studied.

Results: Based on the study reports, TSCI/SCIs and their complication management were highly influenced by the health system's performance. In particular, the health system structure and medical process were identified to affect patient outcomes. According to the QoC study reports, several recommendations, including goal setting by emergency medical service providers to transport patients with possible spinal injury to first care facilities in <1 h and to an equipped care facility in <8 h, the dedication of operating room available 24/7 for patients with TSC/SCIs in referral centers, the distinction between early vs late surgery in patients with TSC/SCIs by healthcare insurance to increase the propensity for early surgery, operating a specialized SCI care unit with trained physicians and personnel in the management of acute complications following SCI and early rehabilitation in referral hospitals were specified.

Conclusion: This article provides a policy brief of this report. The role of the health system and medical process, as well as addressing TSC/SCIs health concerns by policymakers and stakeholders in the Ministry of Health and the parliament, to improve the QoC for patients with TSC/SCIs are discussed.