Economic Evaluation

Australia

New and Jackson (2010) evaluated the 2004 cost of hospitalizations after SCI in Victoria, Australia using administrative data. Gross costs were measured as mean and median per episode costs and were stratified by initial hospitalizations and subsequent hospitalizations. The data was also stratified for traumatic and non-traumatic SCI. Results are presented in Table 2 and 3.

Mean hospital cost per episode
Initial hospitalization Subsequent hospitalizations
Traumatic SCI $52,287 $10,720
Non-traumatic SCI $17,868 $17,352

Median hospital cost (25%-75% interquartile range)
Initial hospitalization Subsequent hospitalizations
Traumatic SCI $23,176 ($5,188-$80,343) $7,106 ($2,340-$11,558)
Non-traumatic SCI $9,620 ($4,476-$17,379) $6,702($3,214-$16,151)

Gabbe and colleagues also calculated the cost of initial hospitalization as a result of SCI in Victoria, Australia. The cost of acute hospitalization per admission in the first 2 years post SCI are presented stratified by the secondary condition reported during the hospitalization. The mean cost of initial hospitalization for the study cohort is $33,716 ($33,169 standard deviation), median of $22,483 ($11,531-$43,149 interquartile range). Acute hospitalization and ED costs per admission or visit were also reported stratified by location and severity of SCI. Results are presented in Table 4 and Table 5.

Secondary condition Cost per admission
Mean (standard deviation) Median (interquartile range)
All conditions $10,731 ($14,821) $6,003 ($3,456-$11,330)
Any urological condition $10,854 ($15,488) $6,134 ($2,261-$11,330)
Pressure injury $22,052 ($24,433) $22,801 ($9,446-$22,801)
Respiratory $19,352 ($25,773) $10,134 ($5,092-$22,801)
Bowel $15,211 ($22,033) $7,772 ($5,092-$22,801)
Fracture $11,121 ($9,859) $6,267 ($4,161-$17,507)
Other $13,454 ($22,637) $5,755 ($4,258-$12,430)

Secondary condition Cost per admission
Mean (standard deviation) Median (interquartile range)
Cervical spine/complete injury $13,033 ($11,631) $10,134 ($5,092-$22,801)
Cervical spine/incomplete injury $9,842 ($14,594) $5,250 ($2,190-$10,225)
Thoracic spine/complete injury $13,103 ($19,112) $6,214 ($5,092-$22,801)
Thoracic spine /incomplete injury $7,704 ($5,815) $5,755 ($5,092-$10,134)
Lumbar $10,307 ($17,911) $5,872 ($3,227-$10,365)

Secondary condition Cost per admission
Mean (standard deviation) Median (interquartile range)
Cervical spine/complete injury $485 ($136) $487 ($350-$591)
Cervical spine/incomplete injury $454 ($152) $487 ($351-$591)
Thoracic spine/complete injury $584 ($49) $591 ($577-$591)
Thoracic spine /incomplete injury $454 ($149) $487 ($298-$577)
Lumbar $404 ($110) $378 ($325-$487)

The cost of initial hospitalization for SCI for individuals above and below the age of 65 was also examined by Mitchell and colleagues in a New South Wales cohort (Mitchell et al. 2018).

The mean hospital cost for traumatic SCI in Australia is approximately $52,000 for initial hospitalization and $10,700 for subsequent hospitalizations; for non-traumatic SCI it is approximately $17,900 for initial hospitalization and $17,350 for subsequent hospitalizations.

The mean cost of a secondary condition results in a hospital visit costing $10,900 for any urological condition to $22,100 for pressure injuries.

The mean cost per hospital visit can range between $7,700 for an individual with incomplete thoracic SCI and $13,100 for a complete thoracic SCI.

The mean cost per emergency department visit is between $404 for lumbar SCI and $584 for complete thoracic SCI.

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