Epidemiology of Traumatic Spinal Cord Injury and Acute Hospitalization and Rehabilitation Charges for Spinal Cord Injuries in Oklahoma, 1988–1990

Abstract

Few injuries result in more profound and long-term disability than traumatic spinal cord injury. This study describes the demographic and epidemiologic characteristics of traumatic spinal cord injury among Oklahoma residents reported to the statewide, population-based surveillance system in 1988-1990; initial acute hospital and rehabilitation charges for 1989 are also included. There was a reported incidence rate of 40 per million population. Based on a reporting sensitivity of 77%, the "true" incidence of spinal cord injury was estimated to be 51 per million population. Motor vehicle crashes accounted for 48% of injuries. Males aged 15-29 years and blacks were at highest risk of injury. Among blacks, the injury rate due to violence was seven times that for whites or Native Americans. Alcohol/drug use was a contributing factor in 39% of injuries and was highest among males aged 20-29 years (58%), Native Americans (57%), and victims of motor vehicle crashes (48%) or violence (51%). The combined initial charges for persons receiving both acute and rehabilitative care ranged from $9,790 to $666,510, with a median of $53,410 per patient; for complete quadriplegia, the combined median charge was $88,585. Despite its low incidence, hospitalization and rehabilitation charges for spinal cord injury in 1989 caused an economic burden of an estimated $8.4 million. While the charges presented were only a small portion of the total costs of spinal cord injury, they further substantiate the need for prevention efforts targeting these debilitating, often permanent injuries. These efforts should target young males and blacks, and should focus on preventing injuries associated with motor vehicle crashes, violence, and alcohol/drug use.

Rehabilitation of spinal cord injury in France: a nationwide multicentre study of incidence and regional disparities

“…1,[4][5][6]8,[10][11][12][13][14][15][16][17][18][19][20][21][22][23] These studies reveal a wide range of incidences, from 10.4 to 56, which can be explained partly by the different methodologies used (retrospective or prospective, mono-or multicentre surveys). The use of medical coding upon admission to register patients allows for a high level of comprehensiveness but sometimes these codes lack reliability and do not always enable to differentiate new cases from old ones.…”

“…Estimations of SCI incidence vary widely, from 8 to 58 SCI persons per million inhabitants per annum (Table 1). Three types of parameters can account for such wide differences: 12 1978-1981 Taiwan 14.6 R, postinjury acute care Gehrig and Michaelis (1986) 13 1960-1967 Switzerland 13.4 R, postinjury acute care, multicentre Biering-Sorensen et al (1990) 24 1975-1984 Denmark 9.2 R, PMR, multicentre Garcia et al (1991) 25 1984-1985 Spain 8 R, PMR, multicentre Acton et al (1993) 14 1980-1989 USA (Arkansas) 28.5 R, postinjury acute care, multicentre Price et al (1994) 15 1988-1990 USA (Oklahoma) 40 R, postinjury acute care and PMR, multicentre Thurman et al (1994) 16 1989-1991 USA (Utah) 43 R, postinjury acute care and PMR, multicentre Knutsdottir (1993) 17 1973-1982 Iceland 24 P, postinjury acute care and PMR [1983][1984][1985][1986][1987][1988][1989] 18 P, postinjury acute care and PMR Lan et al (1993) 18 1986-1990 Taiwan (rural areas) 56 R, postinjury acute care, multicentre Shingu et al (1994) 4 1990 Japan 39.4 R, postinjury acute care and PMR, multicentre 50. 5 Inclusion of forms of ASIA E Soopramanien (1994) 5 1992-1993 Romania 18.5 R, postinjury acute care, 1 unit 28.…”

A cost analysis of conservative management of spinal cord-injured patients in Nigeria

“…The population-based rate of SCI over the last 30 years has remained stable at B40-50 per million population in the developed countries. 1,2 With an average incidence of 11 000 cases year À1 , resulting in an estimated 4 billion dollars of medical and supportive care costs, the human and economic costs of these injuries are substantial. 3 Many studies [4][5][6][7][8][9][10][11][12][13][14] have estimated the financial burden of injury to a patient, his family and the society in developed countries; however, few studies have focused on the financial burden of SCI in the developing countries.…”

Pediatric spinal cord injury in a subset of European countries

“…3 PedSCI is reported to be rare. [4][5][6][7][8][9][10][11][12][13][14] A low incidence and prevalence may result in scattered experiences in treatment and a low priority given to development of research and care programs. 15 Thus, there is a need for increased exchange of information, experiences and best practice between countries.…”