STUDY DESIGN: Retrospective observational study.

OBJECTIVE: The study aims to evaluate the effects of early transfer of individuals with traumatic spinal cord injuries to a specialist

spinal injury centre, focusing on the duration of hospital and intensive care stays, as well as the incidence of medical complications.

SETTING: Regional Spinal Injuries Centre, UK.

PATIENTS AND METHODS: All patients with traumatic SCI admitted over a 4-year period to our Regional Spinal Injury Centre were

included in this study. A total of 104 patients were divided into 2 groups: those referred within 48 h (34 patients) and those referred

later after the injury but within 2 months of injury (70 patients). There were no differences in the number of patients with

tetraplegia or paraplegia or in the average age or sex between the two groups. there is no significant difference in the incidence of

associated injuries between the 2 groups.

RESULTS: Patients who were transferred early stayed less in the ICU than did those who were transferred late (9 and 25 days,

respectively; p < 0.05). The percentage of patients requiring ICU stay was also significantly lower (from 41–9%; p < 0.001); 24% of

patients in the early group had medical complications, while 45% of patients in the delayed group had these complications

(p < 0.05).The average length of hospital stay ( ± SD), including rehabilitation, in the early admission group was 121 (86.9) days,

while that in the delayed admission group was 188 (84.9) days (p < 0.0001).

CONCLUSION: Earlier admission of traumatic SCI patients to a spinal injury centre is associated with shorter acute care period,

shorter total hospital stay and reduced preventable complications.

The extra demand imposed upon the Libyan health services during and after the Libyan revolution in 2011

led the ailing health systems to collapse. To start the planning process to re-engineer the health sector, the

Libyan Ministry of Health in collaboration with the World Health Organisation (WHO) and other

international experts in the field sponsored the National Health Systems Conference in Tripoli, Libya,

between the 26th and the 30th of August 2012. The aim of this conference was to study how health systems

function at the international arena and to facilitate a consultative process between 500 Libyan health experts

in order to identify the problems within the Libyan health system and propose potential solutions. The

scientific programme adopted the WHO health care system framework and used its six system building

blocks: i) Health Governance; ii) Health Care Finance; iii) Health Service Delivery; iv) Human Resources

for Health; v) Pharmaceuticals and Health Technology; and vi) Health Information System. The experts

used a structured approach starting with clarifying the concepts, evaluating the current status of that health

system block in Libya, thereby identifying the strengths, weaknesses, and major deficiencies. This article

summarises the 500 health expert recommendations that seized the opportunity to map a modern health

systems to take the Libyan health sector into the 21st century.