The lifetime cost of spinal cord injury in Ontario, Canada: A population-based study from the perspective of the public health care payer

J Spinal Cord Med. 2019 Mar;42(2):184-193. doi: 10.1080/10790268.2018.1486622. Epub 2018 Jun 20.


Objective: To determine the publicly funded health care system lifetime cost-of-illness of spinal cord injury (SCI) from the perspective of the Ontario Ministry of Health and Long-term Care.

Methods: Individuals hospitalized for their first SCI between the years 2005 and 2011 were identified and their health care costs were calculated using Ontario administrative health care data. From this information, lifetime costs were estimated using phase-based costing methods. The spinal cord injured cohort was matched to a non-spinal cord injured using propensity score matching. Net costs were determined by calculating the difference in costs between the two matched groups. Net costs were also presented for subgroups stratified by demographic characteristics.

Results: A total of 1,716 individuals with SCI were identified and matched in our study. The net lifetime cost of SCI was $336,000 per person. Much of the costs were observed in the first year post-SCI. The lifetime cost of SCI for individuals with a concurrent pressure ulcer at the initial hospitalization rises to $479,600. Costs were also higher for individuals with cervical or thoracic injury or requiring inpatient rehabilitation.

Conclusions: Spinal cord injury is a substantial burden to the health care system. Our results are limited to the direct health care costs from the publicly funded health care payer perspective. Further analysis with a broader perspective is needed to understand the full economic impact of this catastrophic condition.

Keywords: Costs and cost analysis; Spinal cord injuries.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cohort Studies
  • Federal Government
  • Female
  • Health Care Costs / statistics & numerical data*
  • Humans
  • Long-Term Care / economics*
  • Male
  • Middle Aged
  • National Health Programs / economics*
  • Ontario / epidemiology
  • Spinal Cord Injuries / economics*
  • Spinal Cord Injuries / epidemiology
  • Spinal Cord Injuries / therapy*
  • Young Adult