DeVivo M J
Department of Rehabilitation Medicine, University of Alabama at Birmingham, USA.
Spinal Cord. 1997 Dec;35(12):809-13. doi: 10.1038/sj.sc.3100501.
A cross-sectional multicenter study was conducted to estimate the direct costs for each cause of spinal cord injury in the United States. Random samples of 227 new injuries and 508 persons 2-16 years postinjury were selected. Prospective data were collected during one year on all charges for emergency medical services, hospitalizations, attendant care, equipment, supplies, medications, environmental modifications, physician and outpatient services, nursing homes, household assistance, vocational rehabilitation, and miscellaneous items. In 1995 dollars, first year charges averaged $233,947 for vehicle crashes, $217,868 for violence, $295,643 for sports, $185,019 for falls and $208,762 for other causes. Recurring annual charges for each cause averaged $33,439, $17,275, $27,488, $26,238 and $23,510, respectively. Using average age at time of injury for each cause, a 2% real discount rate, and the most recent survival data from the National Spinal Cord Injury Statistical Center, average lifetime charges for each cause were $969,659, $613,345, $950,973, $630,453 and $673,749, respectively. Given an estimated 10,000 new cases of spinal cord injury occurring each year of which 35.9% are caused by vehicle crashes, 29.5% are caused by violence, 20.3% are caused by falls, 7.3% are caused by sports, and 7% result from other causes, annual aggregate direct costs of traumatic spinal cord injury in the United States are $3.48 billion for vehicle crashes, $1.81 billion for violence, $1.28 billion for falls, $694 million for sports and $472 million for other causes. Total direct costs for all causes of SCI in the United States are $7.736 billion.
开展了一项横断面多中心研究，以估算美国脊髓损伤各病因的直接成本。选取了227例新损伤病例的随机样本以及508例受伤后2至16年的患者。前瞻性数据收集了一年，涵盖急诊医疗服务、住院治疗、护理照料、设备、用品、药物、环境改造、医生及门诊服务、疗养院、家庭援助、职业康复以及杂项等所有费用。以1995年美元计，车祸导致的脊髓损伤首年费用平均为233,947美元，暴力导致的为217,868美元，运动导致的为295,643美元，跌倒导致的为185,019美元，其他原因导致的为208,762美元。各病因的年度经常性费用平均分别为33,439美元、17,275美元、27,488美元、26,238美元和23,510美元。利用各病因损伤时的平均年龄、2%的实际贴现率以及国家脊髓损伤统计中心的最新生存数据，各病因的平均终身费用分别为969,659美元、613,345美元、950,973美元、630,453美元和673,749美元。假定美国每年估计有10,000例新的脊髓损伤病例，其中35.9%由车祸导致，29.5%由暴力导致，20.3%由跌倒导致，7.3%由运动导致，7%由其他原因导致，那么美国创伤性脊髓损伤的年度直接总成本中，车祸为34.8亿美元，暴力为18.1亿美元，跌倒为12.8亿美元，运动为6.94亿美元，其他原因为4.72亿美元。美国脊髓损伤所有病因的直接总成本为77.36亿美元。
