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Abstract
Background: Spinal cord injury (SCI) affects hundreds of Texans, with annual healthcare costs exceeding $43,800 per individual, with the bulk of these costs coming from frequent rehabilitation visits. In a geographically vast state with only two major SCI rehabilitation centers, Texans with SCI may face substantial barriers to accessing specialized care, particularly in rural and underserved areas. Telemedicine, which encompasses remote delivery of healthcare services and rehabilitation, has offered promising solutions in easing travel burden and improving physician reach. For example, nationally, in 2021, 37.0% of individuals utilized telemedicine. Furthermore, telemedicine usage was greatest among individuals living in West and Northeast United States, individuals with increased education level, families with incomes at or above 200% of FPL, and large metropolitan areas. However, implementation of telemedicine in SCI raises questions about population needs, quality of care and cost implication. Here, we evaluated the epidemiological spread of SCI in Texas to determine how telemedicine may enhance accessibility, affordability and quality of SCI care in Texas, while also advancing inclusivity in SCI research.
Methods: We conducted a retrospective analysis of a publicly available trauma dataset from the Department of State Health Services in Texas from 2018 to 2022. Specifically, we extracted all entries for SCI (cervical, lumbar and thoracic) using ICD-10 codes for the cause of injury. For all data, we evaluated demographics (e.g. age, ethnicity, race), type of care (e.g. hospital disposition), location of injury (e.g. 3-digit zip code). payment method (e.g., private, insurance). Data were analyzed in R and chi-square tests examined the associations.
Results: We observed a significant increase in SCI in males compared to females and among White individuals compared to other racial/ethnic groups. SCI incidence was elevated in young adults to seniors relative to children/teens and elderly individuals. Motor vehicle accidents were the leading cause of SCI, followed by falls and contact-related injuries. Most patients were discharged home without services, followed by inpatient rehabilitation. Many SCI injuries were Cervical (69%), followed by Thoracic (22%) and Lumbar (21%). A geographical analysis of patient residences and the distribution of specialized physicians revealed limited proximity to practitioners.
Conclusions: Our data indicates that approximately 50% of SCIs in Texas occur in minority individuals. In addition, geographically, most injuries appear to occur in rural settings that may be up to 6 hours away from a SCI rehabilitation center. Telemedicine offers a practical and effective avenue in reducing travel distances and delivering quality care for a wide range of SCI-related concerns. The significant cost savings and reduction in travel provided by telemedicine may alleviate financial burdens of disease on individuals and the overall healthcare system, in addition to improving accessibility for patients with limited access to specialized providers needed to treat complex spinal cord injuries. By prioritizing investments in technology and training, Texas can expand access to telemedicine and enhance health outcomes for SCI patients across the state. Further research and policy initiatives should aim to build on these findings to ensure equitable and effective telemedicine services for all.
Recommended Citation
Murambadoro, Anesu Karen; Salinas, Daniel; Elizondo, Victoria; Garcia Valdez, Kevin; Martin, Blake; Bonilla, Paul; and Baker, Kelsey, "Could Telemedicine Approaches Improve Inclusivity in Spinal Cord Injury Care and Research?: Insights from Epidemiological Texas Data" (2025). Research Symposium. 12.
https://scholarworks.utrgv.edu/somrs/2025/posters/12
Included in
Could Telemedicine Approaches Improve Inclusivity in Spinal Cord Injury Care and Research?: Insights from Epidemiological Texas Data
Background: Spinal cord injury (SCI) affects hundreds of Texans, with annual healthcare costs exceeding $43,800 per individual, with the bulk of these costs coming from frequent rehabilitation visits. In a geographically vast state with only two major SCI rehabilitation centers, Texans with SCI may face substantial barriers to accessing specialized care, particularly in rural and underserved areas. Telemedicine, which encompasses remote delivery of healthcare services and rehabilitation, has offered promising solutions in easing travel burden and improving physician reach. For example, nationally, in 2021, 37.0% of individuals utilized telemedicine. Furthermore, telemedicine usage was greatest among individuals living in West and Northeast United States, individuals with increased education level, families with incomes at or above 200% of FPL, and large metropolitan areas. However, implementation of telemedicine in SCI raises questions about population needs, quality of care and cost implication. Here, we evaluated the epidemiological spread of SCI in Texas to determine how telemedicine may enhance accessibility, affordability and quality of SCI care in Texas, while also advancing inclusivity in SCI research.
Methods: We conducted a retrospective analysis of a publicly available trauma dataset from the Department of State Health Services in Texas from 2018 to 2022. Specifically, we extracted all entries for SCI (cervical, lumbar and thoracic) using ICD-10 codes for the cause of injury. For all data, we evaluated demographics (e.g. age, ethnicity, race), type of care (e.g. hospital disposition), location of injury (e.g. 3-digit zip code). payment method (e.g., private, insurance). Data were analyzed in R and chi-square tests examined the associations.
Results: We observed a significant increase in SCI in males compared to females and among White individuals compared to other racial/ethnic groups. SCI incidence was elevated in young adults to seniors relative to children/teens and elderly individuals. Motor vehicle accidents were the leading cause of SCI, followed by falls and contact-related injuries. Most patients were discharged home without services, followed by inpatient rehabilitation. Many SCI injuries were Cervical (69%), followed by Thoracic (22%) and Lumbar (21%). A geographical analysis of patient residences and the distribution of specialized physicians revealed limited proximity to practitioners.
Conclusions: Our data indicates that approximately 50% of SCIs in Texas occur in minority individuals. In addition, geographically, most injuries appear to occur in rural settings that may be up to 6 hours away from a SCI rehabilitation center. Telemedicine offers a practical and effective avenue in reducing travel distances and delivering quality care for a wide range of SCI-related concerns. The significant cost savings and reduction in travel provided by telemedicine may alleviate financial burdens of disease on individuals and the overall healthcare system, in addition to improving accessibility for patients with limited access to specialized providers needed to treat complex spinal cord injuries. By prioritizing investments in technology and training, Texas can expand access to telemedicine and enhance health outcomes for SCI patients across the state. Further research and policy initiatives should aim to build on these findings to ensure equitable and effective telemedicine services for all.
