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PubMed1997

Trends in the treatment of patients with spinal cord lesions seen within a period of 20 years in German centers.

Twenty-one special centers are running treatment of spinal cord injuries in Germany. Their heads represent a study group to coordinate methods and to investigate results collecting data since 1976. So we have experiences for about 20 years. 1500 recent cases are treated per annum. Seventy-five percent got their lesion by trauma. Beside these there is only a little capacity to treat patients with non-traumatic or congenital lesions (25%). Sixty-two percent are para-, 38% are tetraplegic, 28% female, 2% are children. Within 22,212 recent cases 35% got their injury by traffic, 14% at work. Sports and diving caused 4%, suicide 5% and killing attempts 1%. Though numbers since 1976 are decreasing, traffic and work are main reasons causing spinal injuries. Readmission reasons are mainly disorders of soft tissues (23%) and the urinary tract (21%). Out-patients are checked in 67% of all cases. All investigation data represent very stable trends within the last 20 years. Altogether the special centers carried out treatment and consultation in about 22,000 recent cases, 45,000 readmissions and 80,000 out-patients.

Accidents↗
PubMedDate not supplied

Motor accident and workers' compensation insurance design for high-quality health outcomes and cost containment.

This paper studies scheme structure and information concerning rehabilitation outcome for claimants under the NSW Motor Accidents Scheme and the NSW Workers' Compensation Scheme. It argues that to ensure effective rehabilitation there is a need for consistent, national accident schemes which provide services regardless of fault. In general, health outcomes will be improved if dispute resolution and estimation of level of disability occur in a context which avoids adversarialism. On the other hand, negligence could best be punished and compensation provided to victims as a result of prosecution for breach of duty of care under the relevant protective legislation. Other vital elements in injury prevention and rehabilitation are more effective risk management, worker representation and information provision at the workplace level. Comparable performance measures for rehabilitation and other service providers are also necessary for the attainment of quality management and evidence-based medicine.

Accidents, Traffic↗