The Economic Burden of Urinary Tract Infection and Pressure Ulceration in Acute Traumatic Spinal Cord Injury Admissions: Evidence for Comparative Economics and Decision Analytics from a Matched Case-Control Study

Abstract

Secondary complications of spinal cord injury (SCI) are a burden to affected individuals and the rest of society. There is limited evidence of the economic burden or cost of complications in SCI populations in Canada, however, which is necessary for comparative economic analyses and decision analytic modeling of possible solutions to these common health problems. Comparative economic analyses can inform resource allocation decisions, but the outputs are only as good as the inputs. In this article, new evidence of the excess or incremental costs of urinary tract infection (UTI) and pressure ulceration (PU) in acute traumatic SCI from an exploratory case series analysis of admissions to a Level I specialized Canadian spine facility (2008-2013) is presented. Participants in a national SCI registry were case-control matched (1:1) on the predicted probability of experiencing UTI or PU during initial acute SCI admission. The excess costs of UTI and PU are estimated as the mean of the differences in total direct acute SCI admission costs (length of stay, accommodation, nursing, pharmacy) from the perspective of the admitting facility between participants matched or paired on demographic and SCI characteristics. Even relatively minor UTI and PU, respectively, added an average of $7,790 (standard deviation [SD] $6,267) and $18,758 (SD $27,574) to the direct cost of acute SCI admission in 2013 Canadian dollars (CAD). This case series analysis established evidence of the excess costs of UTI and PU in acute SCI admissions, which will support decision-informing analyses in SCI.

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ICT-Based Health Care Services for People with Spinal Cord Injury: A Pilot Study

“…Traditionally, complications are managed regularly by a doctor at a hospital. However, people with spinal cord injuries have difficulty in accessing medical services due to the inconvenience of movement due to physical impairment and the economic burden on hospital expenses [10,11]. Therefore, recently, a service for managing health by using a remote system has been provided [12,13].…”

The global burden of pressure ulcers among patients with spinal cord injury: a systematic review and meta-analysis

“…Spinal cord injury (SCI) is a life-threatening and debilitating injury with tremendous immediate and long-term extensive impact on the medical, social, psychological and economic aspects of clients, their caregivers and the society [1][2][3]. The annual incidence rate of SCI is 44 cases per 1 000 000 people in Tehran [4], and in European countries ranges from 5.5 to 195.4 cases per million inhabitants [5].…”