SCI FACTS & COSTS |
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Laurance Johnston, Ph.D.
Sponsor: Institute of Spinal Cord Injury, Iceland |
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SCI
prevalence and incidence varies throughout the world for a variety
of societal reasons, including, for example, automobile usage and
the availability of quality health care that allows post-injury
survival. Although comprehensive data is lacking, it is estimated
that 1.5 to 5.2-million individuals with SCI are living throughout
the world, including about 250,000 in the U.S., 330,000 in the
Council-of-Europe member countries, and 420,000 in China. Clearly,
SCI is a disorder that bows to no flag.
Motor-vehicle accidents are usually the leading cause of SCI. For
example, in the US, they account for approximately 44-47% of SCI
cases. For a variety of reasons (e.g., risk-taking behaviors), SCI
inordinately affects young men (~80%). Due to medical and
rehabilitative advances available in developed nations, people with
SCI often approach a near-average live expectancy.
COST
Because SCI typically affects young adults with near-normal life
expectancy, they face immense lifetime, SCI-associated expenses,
as well as compromised earnings and societal contributions.
Summarized below for the U.S., the costs must be shouldered
either by the individual, their family, or society.
Average Yearly Expenses (May 2006 dollars)
Severity of Injury |
First Year |
Subsequent Years |
High Tetraplegia (C1-C4) |
$741,425 |
$132,807 |
Low Tetraplegia (C5-C8) |
$478,782 |
$54,400 |
Paraplegia |
$270,914 |
$27,568 |
Incomplete Motor Functional at any
Level |
$218,505 |
$15,313 |
Estimate Lifetime Costs by Age at Injury (discounted at 2%)
Severity of Injury |
25 years old |
50 years old |
High Tetraplegia (C1-C4) |
$2,924,513 |
$1,721,677 |
Low Tetraplegia (C5-C8) |
$1,653,607 |
$1,047, 189 |
Paraplegia |
$977,142 |
$666,473 |
Incomplete Motor Functional at any
Level |
$651,827 |
$472,392 |
In addition, there are the costs associated with lost
productivity after SCI, for example, lost wages and fringe
benefits. Although dependent on the injury level, and the
individual’s educational level and pre-injury employment, it is
estimated that these costs average $59,212 per year.
In the U.S., 250,000 cases of SCI (using a mid-level
$1.5-million lifetime cost) correspond to a cumulative societal
cost of $375-billion.
Further
documenting the personal economic impact, especially in
countries that don’t have universal health-care coverage, recent
studies suggest that the costs associated with sustaining SCI or
a traumatic brain injury increases considerably the possibility
of bankruptcy. Because individuals sustaining these injuries
often are unable to access adequate financial support to deal
with these huge medical costs, they have to discharge their
debts in bankruptcy courts. Specifically, these studies showed
that in the U.S. the incidence of bankruptcy increased by 33% in
the five years after injury.
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