Spinal Cord Injury: An Analysis of Medical and Social Costs

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Spinal cord injury has devastating consequences for the person involved. An initial period of hospitalization is followed by a period of readjustment and rehabilitation in which the person with SCI must learn a new way of life. These changes have a cost that is borne by the person involved, their families and friends, and society at large.

• SCI costs the nation more than $9.73 billion per year.
• Each newly injured person with SCI incurs total first year costs that average $2.367 billion.
• Annual SCI-related medical care costs average $1.624 billion per year.
• Medications and supplies cost $449 million annually for those beyond their first year post-injury.
• The average cost of personal assistance is estimated to be $2.068 billion for those who are beyond the first year post-injury.

These are the obvious direct costs that must be borne by persons with SCI or by someone on their behalf. When viewed from a societal point of view, SCI also imposes huge indirect costs. Such costs do not arise from anyone's purchase of goods or services but from the losses that come about as persons with SCI are forced to stop work or to reduce their productive activities. Taking these costs into account the authors estimate that:

• Losses of productivity, the indirect costs of SCI, are approximately $2.591 billion nationwide.
• Over the course of the post-injury lifetime, a person with SCI can expect to expend anywhere from $292,800 to $880,700 for injury-related costs, and to lose anywhere from $296,800 to $440,100 in lifetime earnings because of the injury.

Data are needed on the details of these costs to provide guidelines for the allocation of funds to improve the quality of care post-injury and to ease the transition to work. The development of new technologies and improvement in the scope and timing of interventions requires both technical expertise and a realistic measure of their economic feasibility. The attempt to identify and quantify the costs of SCI is a step in the direction of supplying such information.

This volume expands and updates information previously presented in 'The Economic Consequences of Traumatic Spinal Cord Injury,' reporting results from a new survey of the costs of spinal cord injury (SCI). It explores in detail the elements that make up both the medical and the nonmedical direct costs of SCI, focusing specifically on the costs of home modifications, vehicle adaptations, and wheelchairs. It also focuses on the determinants of employment for persons with this traumatic condition.

The population sample was obtained by using lists supplied by hospitals that are members of the Spinal Cord Model Systems, together with names from the membership list of the Paralyzed Veterans of America.

This volume is important reading for everyone who is involved in the acute management and long-term care of persons with SCI.