Chan Brian Chun-Fai, Cadarette Suzanne M, Wodchis Walter P, Krahn Murray D, Mittmann Nicole
a Leslie Dan Faculty of Pharmacy , University of Toronto , Toronto , Canada.
b Institute for Clinical Evaluative Sciences , Toronto , Canada.
J Spinal Cord Med. 2019 Mar;42(2):184-193. doi: 10.1080/10790268.2018.1486622. Epub 2018 Jun 20.
To determine the publicly funded health care system lifetime cost-of-illness of spinal cord injury (SCI) from the perspective of the Ontario Ministry of Health and Long-term Care.
Individuals hospitalized for their first SCI between the years 2005 and 2011 were identified and their health care costs were calculated using Ontario administrative health care data. From this information, lifetime costs were estimated using phase-based costing methods. The spinal cord injured cohort was matched to a non-spinal cord injured using propensity score matching. Net costs were determined by calculating the difference in costs between the two matched groups. Net costs were also presented for subgroups stratified by demographic characteristics.
A total of 1,716 individuals with SCI were identified and matched in our study. The net lifetime cost of SCI was $336,000 per person. Much of the costs were observed in the first year post-SCI. The lifetime cost of SCI for individuals with a concurrent pressure ulcer at the initial hospitalization rises to $479,600. Costs were also higher for individuals with cervical or thoracic injury or requiring inpatient rehabilitation.
Spinal cord injury is a substantial burden to the health care system. Our results are limited to the direct health care costs from the publicly funded health care payer perspective. Further analysis with a broader perspective is needed to understand the full economic impact of this catastrophic condition.
从安大略省卫生和长期护理部的角度，确定脊髓损伤（SCI）的公共资助医疗保健系统终身疾病成本。
确定2005年至2011年间因首次脊髓损伤住院的个体，并使用安大略省行政医疗保健数据计算其医疗保健成本。根据这些信息，使用基于阶段的成本核算方法估算终身成本。使用倾向得分匹配将脊髓损伤队列与非脊髓损伤队列进行匹配。通过计算两个匹配组之间的成本差异来确定净成本。还按人口统计学特征分层呈现了亚组的净成本。
在我们的研究中，共识别并匹配了1716例脊髓损伤个体。脊髓损伤的人均终身净成本为33.6万美元。大部分成本在脊髓损伤后的第一年出现。初次住院时并发压疮的个体脊髓损伤终身成本升至47.96万美元。颈椎或胸椎损伤或需要住院康复的个体成本也更高。
脊髓损伤给医疗保健系统带来了沉重负担。我们的结果仅限于从公共资助医疗保健支付方角度的直接医疗保健成本。需要从更广泛的角度进行进一步分析，以了解这种灾难性疾病的全面经济影响。
