Trends in nonroutine physician visits and hospitalizations: findings among five cohorts from the Spinal Cord Injury Longitudinal Aging Study

Longitudinal cohort study To evaluate lifetime variation in healthcare utilization among individuals with a chronic spinal cord injury (SCI). Medical university in the Southeastern United States (US). Participants were identified from two Midwestern University hospitals and a specialty hospital in the Southeastern US and were enrolled in 1973–1974, 1984–1985, 1993–1994, and 2003–2004. Generalized linear mixed models were used to explore changes in nonroutine physician visits, hospitalizations, and days hospitalized within the 24 months prior to the study. Significant temporal linear spline change was found for nonroutine physician visits. The proportion of participants reporting ≥10 nonroutine physician visits in the 24 months prior to assessment kept relatively constant over the 30 years post injury (p value of trend: p = 0.605) and sharply increased afterwards (pknot = 30 years since injury = 0.016). The trajectory for hospitalization and days hospitalized followed a quadratic pattern (pyears post injury2