Understanding and modelling the economic impact of spinal cord injuries in the United Kingdom

Abstract

Study designEconomic modelling analysis.ObjectivesTo determine lifetime direct and indirect costs from initial hospitalisation of all expected new traumatic and non-traumatic spinal cord injuries (SCI) over 12 months.SettingUnited Kingdom (UK).MethodsIncidence-based approach to assessing costs from a societal perspective, including immediate and ongoing health, rehabilitation and long-term care directly attributable to SCI, as well as aids and adaptations, unpaid informal care and participation in employment. The model accounts for differences in injury severity, gender, age at onset and life expectancy.ResultsLifetime costs for an expected 1270 new cases of SCI per annum conservatively estimated as £1.43 billion (2016 prices). This equates to a mean £1.12 million (median £0.72 million) per SCI case, ranging from £0.47 million (median £0.40 million) for an AIS grade D injury to £1.87 million (median £1.95 million) for tetraplegia AIS A–C grade injuries. Seventy-one percent of lifetime costs potentially are paid by the public purse with remaining costs due to reduced employment and carer time.ConclusionsDespite the magnitude of costs, and being comparable with international estimates, this first analysis of SCI costs in the UK is likely to be conservative. Findings are particularly sensitive to the level and costs of long-term home and residential care. The analysis demonstrates how modelling can be used to highlight economic impacts of SCI rapidly to policymakers, illustrate how changes in future patterns of injury influence costs and help inform future economic evaluations of actions to prevent and/or reduce the impact of SCIs.

Routinely Measured Hematological Markers Can Help to Predict American Spinal Injury Association Impairment Scale Scores after Spinal Cord Injury

“…The lifetime cost of SCI in the UK is estimated to be £1.12 million (mean value) per case, with the total cost of SCI in 2016 in the UK being £1.43 billion. 5 SCI can lead to secondary conditions that increase morbidity and mortality, including respiratory complications, deep vein thrombosis, muscle spasms, urinary tract infections, osteoporosis, pressure ulcers, risk of fracture, and chronic pain. Further, patients with SCI are often rendered dependent on caregivers and show markedly higher rates of mental illness relative to the general population.…”

Management of acute spinal cord injury: A summary of the evidence pertaining to the acute management, operative and non-operative management

“…In the United Kingdom, major trauma is the most significant cause of mortality in the under-50s[ 2 ], and survivors can be left with permanent disabilities. There are an estimated 1200 traumatic spinal cord injuries in the United Kingdom annually[ 3 ], and around 40000 people currently live with long term disabilities following SCI[ 4 ] although certain charities believe this may be higher[ 5 ]. Approximately 14% of spinal fractures damage the spinal cord, of which 50% are incomplete[ 6 ].…”

A Retrospective Pilot Study for Preoperative Screening to Prevent Iatrogenic Cervical Spinal Cord Injury

“…Finally, patients with spinal cord injury often require extensive medical attention and resources due to the propensity of these injuries for lengthier hospital stays, long-term disability, and high frequency of hospital readmission. While the literature is limited in regard to cost analysis of spinal cord injury (SCI) care, it is clear that long-term management of SCI is associated with a significant financial burden in addition to the long-term disabilities and comorbidities incurred [ 29 , 30 ]. Therefore, adapting a cervical spine clearance protocol for preoperative evaluation of patients with increased risk of iatrogenic SCI could aid in reducing postoperative spinal cord complications and associated healthcare costs.…”