Study of cost determinants in the care of subjects with traumatic spinal cord injury
DOI:
https://doi.org/10.11606/issn.2317-0190.v30i1a206648Keywords:
Spinal Cord Injuries, Costs and Cost Analysis, Length os Stay, Postoperative Complications, RehabilitationAbstract
Spinal cord injury (SCI) is the main etiology related to spinal cord injury in young men. Due to the complexity of health care for these patients and their complications, the costs involved in these cases are high. Objective: To evaluate the costs associated with hospital and outpatient care for patients with traumatic spinal cord injury at a university service. Methods: This study was based on the review of clinical information about spinal cord injury and its complications, as well as the search for monetary amounts related to inpatient and outpatient care of individuals with traumatic SCI in a university service in 2009. Results: There were 51 patients with spinal trauma, of which 14 had SCI (age= 38.9 ± 20.8 years; men: 86%). Costs were R$402,908.68 in the absence of spinal cord injury and R$304,433.77 with spinal cord injury, and were statistically associated to the length of stay, the number of clinical complications and surgical procedures. Rehabilitation accounted for 23% of costs for patients with SCI. Conclusion: The costs related to the care of patients with SCI are higher than those associated with spinal trauma without neurological damage. The number of clinical complications is directly correlated with the length of hospital stay and the costs of this care. Rehabilitation corresponds to a smaller part of the expenses in the care of patients with SCI.
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References
Tuono VL. Traumas de coluna no Brasil: análise das internações hospitalares [Dissertação]. São Paulo: Universidade de São Paulo; 2008.
Vasconcelos ECLM, Riberto M. Caracterização clínica e das fraturas da coluna vertebral no município de Ribeirão Preto, propostas para um programa de prevenção do trauma raquimedular. Coluna/Columna. 2011;10(1):40-43 Doi: https://doi.org/10.1590/S1808-18512011000100007
Faleiros F, Marcossi M, Ribeiro O, Tholl A, Freitas G, Riberto M. Epidemiological profile of spinal cord injury in Brazil. J Spinal Cord Med. 2023;46(1):75-82. Doi: https://doi.org/10.1080/10790268.2021.1947679
Custódio NRO, Carneiro MRF, Campelo C, Lima GHS, Jubé MRR, Watanabe LE, et al. Lesão medular no Centro de Reabilitação e Readaptação Dr. Henrique Santillo. Colu-na/Columna. 2009;8(3):265-8. Doi: https://doi.org/10.1590/S1808-18512009000300005
Riberto M, Wu LJL, Souza DR. Rehabilitation and wheelchair users after spinal cord injury: an overview. In: Rajendram R, Preedy VR, Martin CR, editors. Cellular, molecular, physiological, and behavioral aspects of spinal cord injury. London: Academic Press; 2022. p. 65-77. Doi: https://doi.org/10.1016/B978-0-12-822427-4.00006-X
National Spinal Cord Injury Statistical Center. 2013 Annual Report - Complete public version [text on the Internet]. Birmingham: NSCISC; c2013 [cited 2022 dez 29]. Available from: https://www.nscisc.uab.edu/PublicDocuments/reports/pdf/2013%20NSCISC%20Annual%20Statistical%20Report%20Complete%20Public%20Version.pdf
French DD, Campbell RR, Sabharwal S, Nelson AL, Palacios PA, Gavin-Dreschnack D. Health care costs for patients with chronic spinal cord injury in the Veterans Health Administration. J Spinal Cord Med. 2007;30(5):477-81. Doi: https://doi.org/10.1080/10790268.2007.11754581
Riberto M, Pinto PPN, Sakamoto H, Battistella LR. Independência funcional de pacientes com lesão medular. Acta Fisi-átr. 2005;12(2):61-6. Doi: https://doi.org/10.5935/0104-7795.20050004
Munce SE, Wodchis WP, Guilcher SJ, Couris CM, Verrier M, Fung K, Craven BC, Jaglal SB. Direct costs of adult traumatic spinal cord injury in Ontario. Spinal Cord. 2013;51(1):64-9. Doi: https://doi.org/10.1038/sc.2012.81
Lo J, Chan L, Flynn S. A Systematic Review of the Incidence, Prevalence, Costs, and Activity and Work Limitations of Am-putation, Osteoarthritis, Rheumatoid Arthritis, Back Pain, Multiple Sclerosis, Spinal Cord Injury, Stroke, and Traumatic Brain Injury in the United States: A 2019 Update. Arch Phys Med Rehabil. 2021;102(1):115-31. Doi: https://doi.org/10.1016/j.apmr.2020.04.001
Riberto M, Jucá SSH, Miyazaki MH, Battistella LR. Sobre o processo de triagem em centros de reabilitação. Acta Fisi-átr. 2010;17(3):130-33. Doi: https://doi.org/10.11606/issn.2317-0190.v17i3a103369
Sinnott PL, Joyce V, Su P, Ottomanelli L, Goetz LL, Wagner TH. Cost-effectiveness of supported employment for veterans with spinal cord injuries. Arch Phys Med Rehabil. 2014;95(7):1254-61. Doi: https://doi.org/10.1016/j.apmr.2014.01.010
Yu W, Wagner TH, Chen S, Barnett PG. Average cost of VA rehabilitation, mental health, and long-term hospital stays. Med Care Res Rev. 2003;60(3 Suppl):40S-53S. Doi: https://doi.org/10.1177/1077558703256724
Jorge LL, de Brito AM, Marchi FH, Hara AC, Battistella LR, Riberto M. New rehabilitation models for neurologic inpatients in Brazil. Disabil Rehabil. 2015;37(3):268-73. Doi: https://doi.org/10.3109/09638288.2014.914585
Celani MG, Spizzichino L, Ricci S, Zampolini M, Franceschini M; Retrospective Study Group on SCI. Spinal cord injury in Italy: A multicenter retrospective study. Arch Phys Med Rehabil. 2001;82(5):589-96. Doi: https://doi.org/10.1053/apmr.2001.21948
New PW, Jackson T. The costs and adverse events associated with hospitalization of patients with spinal cord injury in Victoria, Australia. Spine (Phila Pa 1976). 2010;35(7):796-802. Doi: https://doi.org/10.1097/BRS.0b013e3181be76f5
Tapia CI, Khalaf K, Berenson K, Globe D, Chancellor M, Carr LK. Health-related quality of life and economic impact of urinary incontinence due to detrusor overactivity associated with a neurologic condition: a systematic review. Health Qual Life Outcomes. 2013;11:13. Doi: https://doi.org/10.1186/1477-7525-11-13
Samuelsson K, Wressle E. Powered wheelchairs and scooters for outdoor mobility: a pilot study on costs and benefits. Disabil Rehabil Assist Technol. 2014;9(4):330-4. Doi: https://doi.org/10.3109/17483107.2013.827244
Kandilakis C, Sasso-Lance E. Exoskeletons for Personal Use After Spinal Cord Injury. Arch Phys Med Rehabil. 2021;102(2):331-7. Doi: https://doi.org/10.1016/j.apmr.2019.05.028
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