Healthcare Utilization

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Lead Author(s): 

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

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD

Spinal cord injury 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 SCI is approximately 54 cases per million population in US, approximately 17,000 new cases of SCI each year. The prevalence is estimated to be 282,000 persons with alive with a SCI in 2016.[2] The patients are initially admitted to acute care unit of hospitals for stabilization in traumatic SCI, further evaluation, acute management with average length of stays: 11 days followed by inpatient rehabilitation with an average 35 days length of stay.1,2
 As cure is limited in most cases of SCI, the patient requires continuous outpatient care including intermittent physical therapy, occupational therapy, pain management, and prevention of complications directly or indirectly related to SCI.


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 healthcare 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 healthcare 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, SCI or disease was diagnosed in 1.56 million healthcare 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 SCIs 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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