The association of the SF-36 health status survey with 1-year socioeconomic outcomes in a chronically disabled spinal disorder population

Study Design. The Short Form Health Survey (SF-36) was administered to pati ents with chronic spinal disorders both before and after tertiary rehabilit ation. The association of the SF-36 with various socioeconomic outcomes was then examined. Objectives. To assess the correlation of scores on SF-36 with treatment pro gram completion and clinically meaningful 1-year socioeconomic outcomes. Summary of Background Data. There has been much interest in identifying var iables that can predict which disabled workers with chronic spinal disorder s will have good versus poor socioeconomic outcomes after tertiary rehabili tation. Results of previous research have indicated that psychosocial facto rs are better predictors of such outcomes than physical factors. A more rec ent trend in research is assessing health-related quality of life from the health care recipient's perspective. Methods. The SF-36 was administered to a cohort (n = 146) of patients chron ically disabled by spinal disorders before entry into a tertiary functional restoration program. Of this cohort, preprogram SF-36 scores and 1-year so cioeconomic data were available for 128 program completers and 18 program n oncompleters. The pre- and postprogram SF-36 scores of program completers f or each of the outcome variables were compared. Results. Better scores on the preprogram SF-36 Social Functioning and Bodil y Pain scales were found to be associated with successful completion of the treatment program. Postprogram SF-36 scores were more frequently associate d with outcomes than were preprogram scores. Most SF-36 scores, especially the physical domain scales, were associated with the variables of return to work, work retention, and use of health care resources. The overwhelming m ajority of significant associations were between higher (i.e., better) SF-3 6 scores and "good" treatment outcomes (e.g., return-to-work). Conclusions. The large number of associations between SF-36 scores end outc ome variables highlights the importance of assessing the health-related qua lity of life of patients, and supports the use of the SF-36 in accomplishin g this task. Among the findings, perhaps the most significant was the value of assessing health-related quality of life, particularly the subjective p hysical components, after completion of a functional restoration program. P rediction of long-term socioeconomic outcomes is likely to be improved if a ssessment is conducted at the end of the treatment process. SF-36 is recomm ended for asessing general health status, and more spine-specific measures are recommended for assessing spinal pain and disability variables.