Understanding and modelling the economic impact of spinal cord injuries in the United Kingdom

• Published in: Spinal cord 2019-09, Vol.57 (9), p.778-788
• Main Authors: McDaid, David, Park, A-La, Gall, Angela, Purcell, Mariel, Bacon, Mark
• Format: Article
• Language: English
• Subjects: 692/700/1538; 692/700/3934; Adaptation; Adolescent; Adult; Aged; Aged, 80 and over; Anatomy; Biomedical and Life Sciences; Biomedicine; Child; Child, Preschool; Cost analysis; Cost assessments; Cost-Benefit Analysis - methods; Cost-Benefit Analysis - trends; Costs; Economic analysis; Economic conditions; Economic impact; Economic models; Female; Health Care Costs - trends; Human Physiology; Humans; Impact analysis; Infant; Infant, Newborn; Injuries; Injury analysis; Life expectancy; Life span; Long-term care; Male; Middle Aged; Modelling; Models, Economic; Neurochemistry; Neuropsychology; Neurosciences; Rehabilitation; Spinal cord injuries; Spinal Cord Injuries - economics; Spinal Cord Injuries - epidemiology; Spinal Cord Injuries - therapy; United Kingdom - epidemiology; Young Adult
• ISSN: 1362-4393; 1476-5624
• DOI: 10.1038/s41393-019-0285-1

Study design Economic modelling analysis. Objectives To determine lifetime direct and indirect costs from initial hospitalisation of all expected new traumatic and non-traumatic spinal cord injuries (SCI) over 12 months. Setting United Kingdom (UK). Methods Incidence-based approach to assessing costs from a societal perspective, including immediate and ongoing health, rehabilitation and long-term care directly attributable to SCI, as well as aids and adaptations, unpaid informal care and participation in employment. The model accounts for differences in injury severity, gender, age at onset and life expectancy. Results Lifetime costs for an expected 1270 new cases of SCI per annum conservatively estimated as £1.43 billion (2016 prices). This equates to a mean £1.12 million (median £0.72 million) per SCI case, ranging from £0.47 million (median £0.40 million) for an AIS grade D injury to £1.87 million (median £1.95 million) for tetraplegia AIS A–C grade injuries. Seventy-one percent of lifetime costs potentially are paid by the public purse with remaining costs due to reduced employment and carer time. Conclusions Despite the magnitude of costs, and being comparable with international estimates, this first analysis of SCI costs in the UK is likely to be conservative. Findings are particularly sensitive to the level and costs of long-term home and residential care. The analysis demonstrates how modelling can be used to highlight economic impacts of SCI rapidly to policymakers, illustrate how changes in future patterns of injury influence costs and help inform future economic evaluations of actions to prevent and/or reduce the impact of SCIs.