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Merritt et al. Neuroimmunol Neuroinflammation 2019;6:9 Neuroimmunology
DOI: 10.20517/2347-8659.2019.15 and Neuroinflammation

Review Open Access

Economic impact of traumatic spinal cord injuries in
the United States

Christopher H. Merritt, Matthew A. Taylor, Caleb J. Yelton, Swapan K. Ray

Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, SC
29209, USA.
Correspondence to: Prof. Swapan K. Ray, Department of Pathology, Microbiology, and Immunology, University of South Carolina
School of Medicine, 6439 Garners Ferry Road, Columbia, SC 29209, USA. E-mail: swapan.ray@uscmed.sc.edu

How to cite this article: Merritt CH, Taylor MA, Yelton CJ, Ray SK. Economic impact of traumatic spinal cord injuries in the United
States. Neuroimmunol Neuroinflammation 2019;6:9. http://dx.doi.org/10.20517/2347-8659.2019.15

Received: 17 Apr 2019 First Decision: 3 Jun 2019 Revised: 6 Jul 2019 Accepted: 8 Jul 2019 Published: 20 Jul 2019

Science Editor: Athanassios Kyritsis Copy Editor: Jia-Jia Meng Production Editor: Jing Yu

Abstract

Individuals having sustained traumatic spinal cord injury (TSCI) in the United States are living longer as compared to
historical trends, thanks to an ever-evolving understanding of the nature of this injury. Despite this, multiple barriers
to care for TSCI patients remain including variations in government-issued veteran insurance, privatized insurance,
and among uninsured individuals. The United States alone experiences 12,000 new TSCI cases every year, many of
these are found to occur in a growing proportion of elderly individuals. It is crucial to understand both the short-term
direct costs as wells as the long-term rehabilitation costs required by these TSCI patients. The lifetime financial
burden for those having sustained a TSCI can be immense for patients, insurance companies, and hospital systems
alike. Among those with TSCI, re-hospitalization rates are high, leading to increased healthcare resource utilization
within this specific patient population. Costs can quickly balloon into hundreds of thousands of dollars and cause
a profound financial burden for these patients. This review article seeks to communicate an understanding of the
current financial landscape surrounding TSCI patients. The authors will also examine the costs of acute emergency
room surgical care such as American spinal injury association grade, hospital length of stay, as well as the timing
delay between injury and surgical decompression. Long-term costs associated with TSCI such as rehabilitation, care
of secondary comorbidities, and post-injury employment prospects will be examined as well. These costs will be
framed from the patient’s perspective as well as from both the hospital and insurance company’s perspectives. It
is hoped a complete understanding as to what makes TSCI such a medically and financially burdensome injury will
allow for improved healthcare resource utilization in this population.

Keywords: Traumatic spinal cord injury, healthcare resource, American spinal injury association grade, hospital
length of stay, rehabilitation, post-injury employment
© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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