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J Neurotrauma. 2017 Oct 15;34(20):2917-2923. doi: 10.1089/neu.2016.4936. Epub 2017 Aug 24.

Forecasting Financial Resources for Future Traumatic Spinal Cord Injury Care Using Simulation Modeling.

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1 University of Toronto Spine Program , Toronto, Ontario, Canada .
2 Centre for Operations Excellence, Sauder School of Business, University of British Columbia , Vancouver, British Columbia, Canada .
3 Rick Hansen Institute , Vancouver, British Columbia, Canada .
4 Department of Orthopaedics, University of British Columbia , Vancouver, British Columbia, Canada .
5 SCI Clinical Research Unit, Toronto Western Hospital , Toronto, Ontario, Canada .
6 Department of Physical Medicine and Rehabilitation, University of Saskatchewan , Saskatoon, Saskatchewan, Canada .
7 Research Division of Neurosurgery, Dalhousie University , Halifax, Nova Scotia, Canada .
8 Sections of Orthopedics and Neurosurgery, University of Manitoba , Winnipeg, Manitoba, Canada .
9 Operations and Logistics Division, Sauder School of Business, University of British Columbia , Vancouver, British Columbia, Canada .


Survivors of traumatic spinal cord injury (tSCI) have intense healthcare needs during acute and rehabilitation care and often through the rest of life. To prepare for a growing and aging population, simulation modeling was used to forecast the change in healthcare financial resources and long-term patient outcomes between 2012 and 2032. The model was developed with data from acute and rehabilitation care facilities across Canada participating in the Access to Care and Timing project. Future population and tSCI incidence for 2012 and 2032 were predicted with data from Statistics Canada and the Canadian Institute for Health Information. The projected tSCI incidence for 2012 was validated with actual data from the Rick Hansen SCI Registry of the participating facilities. Using a medium growth scenario, in 2032, the projected median age of persons with tSCI is 57 and persons 61 and older will account for 46% of injuries. Admissions to acute and rehabilitation facilities in 2032 were projected to increase by 31% and 25%, respectively. Because of the demographic shift to an older population, an increase in total population life expectancy with tSCI of 13% was observed despite a 22% increase in total life years lost to tSCI between 2012 and 2032. Care cost increased 54%, and rest of life cost increased 37% in 2032, translating to an additional CAD $16.4 million. With the demographics and management of tSCI changing with an aging population, accurate projections for the increased demand on resources will be critical for decision makers when planning the delivery of healthcare after tSCI.


forecasting; healthcare cost; incidence; simulation modeling; traumatic spinal cord injury

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