Healthcare Inequity in Spinal Cord Injury: Out of Pocket and Access Barriers in Paraplegic and Tetraplegic…

Cross-sectionalKorean journal of neurotrauma· Jul 2026

Healthcare Inequity in Spinal Cord Injury: Out of Pocket and Access Barriers in Paraplegic and Tetraplegic Patients in Iran.

Ali Alavi-Badabsari, Alireza Ahmadi-Veshno, Seyyed Pouyan Zadparast … Enayatollah Homaie Rad

Spinal Cord Injury RehabilitationCross-sectionalClinical practiceQ2IF 1.4

Mental health services show the largest pro-rich access gap in spinal cord injury care

Healthcare Inequity in Spinal Cord Injury: Out of Pocket and Access Barriers in Paraplegic and Tetraplegic Patients in Iran.

Ali Alavi-Badabsari … Enayatollah Homaie Rad

Korean journal of neurotrauma · Jul 2026

Background

Spinal cord injury (spinal cord injury) imposes substantial long-term physical, psychological, as well as financial burdens on patients in Iran, where high out-of-pocket (OOP) payments remain a major barrier to care.

Purpose

This study examined inequalities in healthcare utilization and OOP expenditures among patients with paraplegia and tetraplegia.

Methods

This cross-sectional analyzed data from the 2023 International Spinal Cord Injury Survey for Iran, including 191 patients from the Guilan Province.

n = 191 patients

0.49

Results

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wealthier patients get far more access to mental health care

n = 191 patients

More results

Inpatient care accounted for the highest OOP cost (US$516.27/month), followed by rehabilitation (US$178.65/month).

Education, marital status, and place of residence significantly influenced the disparities, with rural and less-educated patients experiencing greater barriers.

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Conclusion · 1 of 2

Patients with spinal cord injury in Iran face substantial financial inequities, and wealthier groups enjoy greater access to essential services.

Conclusion · 2 of 2

Policy reforms aimed at expanding insurance coverage, decentralizing rehabilitation, and subsidizing high-cost care are urgently required to promote equitable healthcare access and improve outcomes.

Healthcare Inequity in Spinal Cord Injury: Out of Pocket and Access Barriers in Paraplegic and Tetraplegic Patients in Iran.

Healthcare Inequity in Spinal Cord Injury: Out of Pocket and Access Barriers in Paraplegic and Tetraplegic Patients in Iran.

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