Application of the Andersen's health care utilization framework to secondary complications of spinal cord injury: a scoping review

Disabil Rehabil. 2012;34(7):531-41. doi: 10.3109/09638288.2011.608150. Epub 2011 Nov 16.


Purpose: The purpose of this scoping review was to identify research priority areas related to secondary complications and associated health care use for individuals with spinal cord injury (SCI).

Data sources: Peer-reviewed journals were identified using CINAHL, MEDLINE, PubMed, Embase, Social Sciences Abstracts, Social Works Abstract and PsycInfo search engines. Key references were hand searched.

Study selection: A total of 289 abstracts were identified from the initial search strategy. We removed studies that did not measure health care and those that did not involve analytical investigation.

Data extraction: The selected 31 studies were reviewed in detail using a coding template based on the domains and sub-components of the Andersen model (i.e. environmental, population characteristics, health behavior and outcome).

Results: Most studies measured predisposing characteristics (e.g., age, gender) and need characteristics (e.g., level of injury). There was a notable absence of environmental characteristics (e.g., health system, neighborhood variables), enabling characteristics and health behaviors (beyond diet and nutrition).

Conclusions: We identified a gap in the SCI literature. Future research should focus on longitudinal study designs with more representation of non-traumatic spinal cord injury, as well as utilizing more advanced statistical analyses (i.e., multivariate level) to adjust for confounding variables.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Behavioral Research
  • Health Behavior*
  • Health Services / statistics & numerical data*
  • Humans
  • Insurance, Health
  • Models, Psychological
  • Spinal Cord Injuries / complications*
  • Spinal Cord Injuries / rehabilitation
  • Spinal Cord Injuries / therapy