Economic impact of traumatic spinal cord injuries in the United States

Neuroimmunol Neuroinflamm, 2019 · DOI: 10.20517/2347-8659.2019.15 · Published: January 1, 2019

Spinal Cord Injury Healthcare Rehabilitation

Simple Explanation

Traumatic spinal cord injuries (TSCIs) present a significant economic burden due to high initial care costs, long-term rehabilitation, and potential complications. The financial strain affects patients, insurance companies, and hospital systems alike. Surgical intervention within 72 hours post-injury is crucial, reducing hospital stays and medical costs while improving neurological recovery. However, rural areas face challenges in providing timely access to such care. Rehabilitation is vital for maximizing neurological recovery and minimizing long-term co-morbidities, but disparities exist in access to rehabilitation services based on insurance coverage. Uninsured patients often face barriers to rehabilitation, leading to decreased functional independence and increased medical emergencies.

Study Duration

Not specified

Participants

303 (in one study) chronic TSCI patients

Evidence Level

Not specified

Key Findings

1
Surgical intervention within 72 hours of TSCI reduces hospital length of stay and medical costs, saving hospitals an average of $14,000 and patients approximately $45,000.
2
Patients with private insurance are more likely to be referred to rehabilitation services compared to those with government insurance or who are uninsured, despite similar injury severities.
3
The first 12 months post-TSCI are the costliest, with average charges of $606,349 per patient, followed by annual long-term care costs of $92,454.

Research Summary

Traumatic spinal cord injury (TSCI) poses a substantial financial challenge, impacting patients, healthcare systems, and insurance providers. The study highlights the significance of early surgical intervention and rehabilitation access for improved outcomes and cost reduction. Variations in insurance coverage lead to disparities in access to rehabilitation, affecting long-term patient outcomes and increasing healthcare costs. Uninsured patients are particularly vulnerable, facing barriers to rehabilitation and a higher risk of medical emergencies. Addressing secondary health conditions and promoting early rehabilitation are crucial steps toward reducing healthcare costs associated with TSCI. Efficient resource allocation and targeted interventions can improve patient outcomes and alleviate the financial burden on individuals and healthcare systems.

Practical Implications

Improve Access to Early Surgical Intervention

Ensure timely surgical intervention (within 72 hours) post-TSCI to reduce hospital stays, lower medical costs, and improve neurological recovery.

Address Insurance Disparities in Rehabilitation Access

Implement policies to ensure equitable access to rehabilitation services for all TSCI patients, regardless of insurance status, to improve long-term outcomes and reduce healthcare costs.

Focus on Prevention of Secondary Health Conditions

Prioritize patient education and rehabilitation programs to prevent secondary health conditions like UTIs, sepsis, and pressure ulcers, which contribute significantly to healthcare costs and reduced quality of life.

Study Limitations

1
The recovery rates corresponding with the time between TSCI and initiation of rehabilitation is not well understood.
2
Unclear if results generalizable beyond the US healthcare system.
3
Lack of specific data on the long-term cost-effectiveness of various interventions.

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