Acta Biomedica Scientia

A RETROSPECTIVE COHORT ANALYSIS OF THE COST OF INPATIENT REHABILITATION AFTER SPINAL INJURY

Veluru Srinivasulu1*, Nagaraju M

Veluru@gmail.com

Traumatic Spine Injury, Value-Driven Outcome, Spinal Cord Injury, Cost

A spinal cord injury (SCI) leads to a lifetime high direct and indirect cost that increases with severity. Although acute rehabilitation has the potential to significantly improve function, its cost has yet to be evaluated despite its potential to improve function. The direct costs associated with rehabilitation after spine injury were analyzed using a proprietary hospital database. Using a retrospective cohort method at a single center, we examined the costs associated with patients with acute, traumatic spine injuries treated at a tertiary facility from 2011 to 2017. According to the American Spinal Injury Association, for each patient (mean age 46.1/18.6 years, 76.3% males) who were identified, their impairment scores on admission were 32.1% A, 14.7% B, 14.7% C, 33.2% D, and 1.1% E. 179 patients (94%) received surgical treatment. The cervical spine suffered the greatest number of injuries (53.2%). After acute rehabilitation, functional impairment scores improved by 30.7, or 16.2. The cost of services included 86.5% for facilities, 9.2% for pharmacies, 2.0% for supplies, 1.5% for laboratories, and 0.8% for imaging. The cost of rehabilitation was unaffected by the level of injury, the severity of the injury, and prior inpatient surgical treatment. Based on a univariate analysis, a higher degree of injury severity (p = 0.0001, one-way ANOVA) and a higher level of injury in the spinal column (p = 0.001, one-way ANOVA) was associated with a longer rehabilitation stay. Nevertheless, length of rehabilitation stay was the most significant independent predictor of higher-than-median costs after taking into account other factors (risk ratio = 1.56, 95% CI 1.22-2.0, p = 0.001). Despite high upfront costs for spine injuries, rehabilitation substantially affects the cost of care. Reduced costs may be achieved by improving the effectiveness of rehabilitation