Healthcare Utilization


Lead Author(s): 

Jonathan S. Kirschner, MD, RMSK
Se Won Lee, MD

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD

SCI is a life changing event affecting a younger population (average age at injury: 42 years old) and it is a cause of major disability. Annual incidence of spinal cord injury is approximately 54 cases per million in the US, with approximately 17,000 new cases of SCI each year. The prevalence is estimated to be 282,000 persons alive with a SCI in 2016.1 Patients are initially admitted to acute care units of hospitals for stabilization for an average length of stay of 11 days followed by inpatient rehabilitation with an average 35 day length of stay.1,2 As cure is limited in most cases of SCI, patients require continuous outpatient care including intermittent physical, occupational and speech therapy, pain management, and prevention of complications directly or indirectly related to SCI including deep vein thrombosis, pressure ulcers, pneumonia and urinary tract infections.


Males account for approximately 80% of new SCI cases each year, with nearly 1 in 4 (22%) injuries occurring to non-Hispanic blacks since 2010, nearly twice the proportion of non-Hispanic blacks in the general population (12%).2   

Analysis by demographic variables is limited by data size for outpatient clinic and physician’s office visits. However, as previously noted, males have a higher rate of SCI health care visits, and age is clearly a factor beginning in middle age around 45. Geographic region does not appear to be a factor. Race/ethnicity is unclear due to missing data cells. However, with a rate of 0.30 per 100 persons compared to 0.25 for all races, SCI health care visits appear to be greater among non-Hispanic whites than in other races/ethnicities. (Reference Table T6B.1.1 PDF CSV; Table 6B.1.2 PDF CSV; Table 6B.1.3 PDF CSV; and Table 6B.1.4 PDF CSV)

Healthcare Resources

In 2013, spinal cord injury or disease was diagnosed in 1.56 million health care visits, representing 1 person in every 200 in the US. However, it is likely more than one visit per person would reduce this ratio. Visits to outpatient clinics and physician’s offices generally do not meet standards of reliability, but for hospital discharges and emergency department visits with a diagnosis of spinal cord injuries and diseases, a diagnosis of ‘other paralytic syndromes’ account for 75% of visits. Nearly half (47%) of visits are to physician’s offices, while 1 in 5 (20%) involves hospitalization. (Reference Table 6B.1.5 PDF CSV)



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