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

Purpose: To explore healthcare utilization patterns and healthcare services satisfaction among individuals with spinal cord injury in Malaysia. Methods: 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. Results: 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 (beta= 0.443), while activity limitation and participation restriction predicted healthcare services satisfaction (beta = -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). Conclusions: 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.