Abstract
PurposeSpine-related disorders are a leading cause of global disability and are a burden on society and to public health. Currently, there is no comprehensive, evidence-based model of care for spine-related disorders, which includes back and neck pain, deformity, spine injury, neurological conditions, spinal diseases, and pathology, that could be applied in global health care settings. The purposes of this paper are to propose: (1) principles to transform the delivery of spine care; (2) an evidence-based model that could be applied globally; and (3) implementation suggestions.MethodsThe Global Spine Care Initiative (GSCI) meetings and literature reviews were synthesized into a seed document and distributed to spine care experts. After three rounds of a modified Delphi process, all participants reached consensus on the final model of care and implementation steps.ResultsSixty-six experts representing 24 countries participated. The GSCI model of care has eight core principles: person-centered, people-centered, biopsychosocial, proactive, evidence-based, integrative, collaborative, and self-sustaining. The model of care includes a classification system and care pathway, levels of care, and a focus on the patient’s journey. The six steps for implementation are initiation and preparation; assessment of the current situation; planning and designing solutions; implementation; assessment and evaluation of program; and sustain program and scale up.ConclusionThe GSCI proposes an evidence-based, practical, sustainable, and scalable model of care representing eight core principles with a six-step implementation plan. The aim of this model is to help transform spine care globally, especially in low- and middle-income countries and underserved communities.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material.
Highlights
Spinal disorders are a leading source of global disability and result in a considerable burden on society [1,2,3,4]
The following is a description of the Global Spine Care Initiative (GSCI) model of care and suggestions for implementation
We believe that the proposed GSCI model of care is the first of its kind to address the global burden of spinal disorders and recent calls for action [7, 23, 109]
Summary
Spinal disorders are a leading source of global disability and result in a considerable burden on society [1,2,3,4]. People in low- and middle-income countries and those in communities under socioeconomic stress are especially affected [5, 6]. Years lived with disability caused merely by low back pain increased by 54% between 1990 and 2015, mainly because of population increase and aging, with the biggest increase seen in low-income and middle-income countries [7]. Costs of care for back pain vary among countries depending on the type of study; total costs demonstrate a substantial financial burden regardless of the variation [8].
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