Employment, health outcomes, and life satisfaction after spinal cord injury: comparison of veterans and nonveterans.

Abstract

Study Design:Retrospective cohort study.Objective:To explore differences between Veterans and Non-Veterans with spinal cord injury (SCI) for employment, health, and satisfaction with life outcomes after controlling for demographic and injury characteristics.Setting:Hospitals in the Spinal Cord Injury Model System of care.Methods:A total of 9,754 (85% Non-Veterans and 15% Veterans) adults with traumatic SCI interviewed from 2000 and 2015 and completed follow-up years 1, 5, and 10 were included in study. Employment status and the Craig Handicap Assessment and Reporting Technique-Short Form (CHART-SF) measured employment. The SF-36 for self-perceived health status, CHART-SF, and rehospitalization determined health outcomes. Satisfaction with life was measured by the Satisfaction with Life Scale (SWLS). Secondary data analysis using chi-squares, t-tests, and generalized estimating equations (GEE) model to determined group differences with control of demographic and injury characteristics.Results:There were no significant differences for employment and SWL between Non-Veterans and Veterans. There were some differences in health outcomes; whereas, Veterans had better physical independence and mobility compared to Non-Veterans.Conclusion:Interventions for both groups should target adults with a disability from SCI, be customized for varying levels of injury that address differences in health care systems, demographic backgrounds, economic resources, disincentives and motivation.