A total of 3 studies investigated SCI cost of illness from a Canadian health care system perspective (Dryden et al. 2005, Bradbury et al. 2008, Munce et al. 2013). Dryden and colleagues (2005) examined a cohort of individuals from Alberta. Costs were stratified by level of injury (tetraplegia versus thoracic versus lumbar) and whether it was complete or incomplete. Results were further stratified for first year after injury and years 2-6. Inpatient hospital, physician, home-care and long-term care costs were included in their analysis. Since this study had a non-SCI comparator both incidence and attributable costs were calculated. Administrative data was used to identify cohort and extract costing information, thus the study is limited by the quality of the administrative data. Results were calculated from 2009 costs.
An Ontario SCI cohort was investigated by Munce and colleagues (2013) using administrative data. Prevalent cost per year for SCI was calculated for inpatient hospital, emergency department visits, physician, home care, long-term care and drugs. Results were presented for fiscal years 2003 to 2005 and were presented in 2005 dollars. The general SCI cohort was explored with no further SCI subgrouping. Regression analyses were conducted to look at factors that may influence increased costs.
Bradbury and colleagues (2008) investigated the cost of rehabilitation in 2006 dollars for individuals with SCI from the perspective of the rehabilitation facility. The primary focus of this study was to investigate the clinical and economic impact of TBI in patients with SCI in a rehabilitation setting. Mean costs for an incidence population were presented and stratified for individuals with and without TBI. Costs per change in functional independence motor score were also computed. In total, 10 patients with TBI and SCI were compared with 10 patients without TBI.
In Canada, mean costs range between $28,000 to $260,000 for initial hospitalization, $270,000 to $40,000 in the first year and $12,000 to $97,000 for following years depending on type of injury. Total mean cost of inpatient rehabilitation is approximately $198,000 for SCI and is increased to approximately $257,000 if the patient also has a TBI. Total mean annual cost per individual with SCI in Ontario is approximately $180,000.