Patient-reported outcomes, rehabilitation utilization, and unmet needs after traumatic spinal cord injury: A regional pilot survey in Korea

CONTEXT: Patient-reported data on long-term rehabilitation outcomes and support policies for individuals with spinal cord injury (SCI) in Korea are lacking. OBJECTIVE: To assess real-world rehabilitation experiences among individuals with traumatic SCI in Korea, focusing on service utilization, satisfaction, barriers to access, unmet needs, and quality of life. DESIGN: Retrospective chart review and cross-sectional survey. SETTING: Regional trauma center between 2016 and 2021. Survey data were collected between October 2023 and March 2024, ensuring a minimum of two years of follow-up after injury for all participants. PARTICIPANTS: Adults with traumatic SCI discharged from the regional trauma center. OUTCOME MEASURES: Variables measured with standardized instruments, including EuroQol 5-Dimension 5-Level questionnaire (EQ-5D-5L) and World Health Organization Quality of Life Brief Version (WHOQOL-BREF). RESULTS: Of the 317 screened individuals, 72 completed the survey. After discharge, 72.2% received outpatient rehabilitation, 29.2% were employed, and 8.3% had returned to their pre-injury job. Employment was significantly associated with higher EQ-5D-5L index and WHOQOL-BREF scores. Greater neurological injury severity (motor complete vs. motor incomplete) and older age were associated with lower EQ-5D-5L and WHOQOL-BREF scores across multiple domains. Household income showed a consistent dose-response relationship with the WHOQOL-BREF Environment domain, indicating better perceived environmental and service-related quality of life with higher income. Major barriers included mobility limitations and transportation challenges. Unmet needs were frequent, with financial assistance (77.8%) and daily living support (37.5%) most requested. CONCLUSIONS: In this single-center survey, individuals with traumatic SCI reported persistent barriers to community reintegration and unmet rehabilitation needs. Quality of life was most consistently associated with injury severity, while household income showed the strongest association with the WHOQOL-BREF Environment domain. Community-based services should be strengthened. A national SCI registry should be established for long-term care planning.