Direct health care costs following traumatic spinal cord injury

Purpose The study objectives were (i) to quantify direct health care costs following traumatic spinal cord injury (SCI) and (ii) to estimate attributable costs per person for the first 6 years post injury. Methods This was a population-based cohort study that followed individuals with SCI and their matched controls for 6 years. Administrative data from a Canadian province with a universal publicly funded health care system and centralized health databases were used. Costs included hospitalizations, physician services, home care, and long-term care. Per-person costs were calculated by dividing the aggregate observed costs by the total number of individuals who sustained a SCI. Multivariable linear regression analysis was used to estimate costs attributable to SCI. Results Overall costs for initial hospitalization were $6.3 million (2002 $CDN). The mean cost per person ranged from $15,400 to $144,600, depending on the level and severity of SCI. After initial hospitalization to 6 years post injury, an additional $2.9 million were incurred. Attributable costs in the first year were $121,600 per person with a complete SCI, and $42,100 per person with an incomplete SCI. In the subsequent five years, annual costs were $5400 and $2800 for persons with complete and incomplete SCIs, respectively. Conclusion This study has provided a comprehensive estimate of the economic impact of SCI in a defined geographical area. Use of administrative data enabled us to estimate costs that are population based, attributable to SCI, based on direct observation, and inclusive of downstream events. The results will be useful to planners to forecast health care costs due to SCI and to researchers conducting studies on the economic value of the prevention of SCI.