Hydronephrosis: an unusual complication of neurogenic bowel in a patient with spinal cord injury: a case report.

STUDY DESIGN/METHODS: Case report. OBJECTIVES: In this case report, a consequence of not following proper care of the bowel affecting the genitourinary system is reported and discussed. SETTING: United States. RESULTS/CONCLUSION: Neurogenic bowel and bladder can result from a spinal cord injury. It is necessary for spinal cord injury patients to continually follow recommended bladder and bowel care programs to decrease complications.

Wheelchair-accessible housing: its role in cost containment in spinal cord injury.

OBJECTIVE: To determine frequency with which the need to find accessible housing delays discharge from an inpatient rehabilitation unit. DESIGN: Retrospective review of the records of all patients (122) admitted with a diagnosis of acute spinal cord injury to the Inpatient Rehabilitation Unit of a teaching hospital between January 1986 and December 1993. SETTING: Tertiary care center's inpatient rehabilitation unit. MAIN OUTCOME MEASURE: A determination of whether each patient was discharged at the time that he or she was ready to leave the Rehabilitation Unit or whether discharge had to be delayed because the patient did not have an accessible home to which he or she could return. RESULTS: Ten percent of the patients had to stay in the hospital beyond the planned date of discharge while their families or representatives of the hospital looked for accessible housing. The delays ranged from 6 to 210 days, with an average delay of 60 days. The hospital's average charge for this time was $29,280. The average savings, had the patient been transferred to a transitional living unit when they were ready for hospital discharge, would have been $27,660. CONCLUSION: The need to find accessible housing should be included in the list of factors that can affect the length of stay of patients admitted to a rehabilitation unit and increase charge for service provided to those patients.