{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T22:36:34Z","timestamp":1788042994231,"version":"build-2784847793"},"reference-count":32,"publisher":"American Spinal Injury Association","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A previous analysis using the Canadian Spinal Cord Injury (SCI) Community Survey data identified that there were individuals with a high number of secondary health conditions, high health care utilization, poor health outcomes, and unmet health care needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The objectives of this study were to estimate the annual health care costs of persons with SCI who report secondary health conditions, and to determine the association between these secondary health conditions with health care utilization and self-reported life satisfaction and quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The survey respondents were divided into four groups: traumatic SCI (tSCI; those who said they received needed care and those who said they did not) and nontraumatic SCI (ntSCI; those who said they received needed care and those who said they did not). The average annual health care costs per respondent were estimated for each group. Using regression analysis, we estimated the change in average annual health care costs that were associated with an additional secondary health condition for respondents in each group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants who reported not receiving needed care had on average 23% more secondary health conditions than those receiving needed care. The increase in average annual health care costs associated with one additional secondary health conditions was between $428 ($37-$820) (ntSCI, receiving needed care) and $1240 ($739-$1741) (tSCI, not receiving needed care).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study provides insight into potential cost savings associated with a reduction of secondary health conditions as well as an estimate of the reduction in health care costs associated with moving from not receiving all needed care to receiving needed care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.46292\/sci22-00039","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T04:44:11Z","timestamp":1692247451000},"page":"80-88","source":"Crossref","is-referenced-by-count":6,"title":["An Economic Analysis of the Association Among Secondary Health Conditions, Health Care Costs, and Quality of Life for Persons With Spinal Cord Injury"],"prefix":"10.46292","volume":"29","author":[{"given":"Craig","family":"Mitton","sequence":"first","affiliation":[{"name":"Centre for Clinical Epidemiology and Evaluation, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Dionne","sequence":"additional","affiliation":[{"name":"Centre for Clinical Epidemiology and Evaluation, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nader","family":"Fallah","sequence":"additional","affiliation":[{"name":"Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada"},{"name":"Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa K.","family":"Noonan","sequence":"additional","affiliation":[{"name":"Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada"},{"name":"Department of Orthopedics, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"25425","reference":[{"key":"i1945-5763-29-3-80-b1","series-title":"Clin Epidemiol","first-page":"309","article-title":"Global prevalence and incidence of traumatic spinal cord injury","volume":"6","author":"Singh\n              A","year":"2014","unstructured":"Singh\n              A\n            , TetreaultL, Kalsi-RyanS, NouriA, FehlingsMG. Global prevalence and incidence of traumatic spinal cord injury. Clin Epidemiol. 2014;6:309-331."},{"issue":"7","key":"i1945-5763-29-3-80-b2","series-title":"Spinal Cord","first-page":"618","article-title":"Prevalence of comorbidities and secondary health conditions among the Finnish population with spinal cord injury","volume":"60","author":"Tallqvist\n              S","year":"2022","unstructured":"Tallqvist\n              S\n            , KauppilaA-M, Vainionp\u00e4\u00e4A, et al.\n          Prevalence of comorbidities and secondary health conditions among the Finnish population with spinal cord injury. Spinal Cord. 2022;60(7):618-27."},{"issue":"3","key":"i1945-5763-29-3-80-b3","series-title":"J Rehabil Med","article-title":"Physical health conditions in persons with spinal cord injury across 21 countries worldwide","volume":"54","author":"Str\u00f8m\n              V","year":"2022","unstructured":"Str\u00f8m\n              V\n            , M\u00e5numG, AroraM, et al.\n          Physical health conditions in persons with spinal cord injury across 21 countries worldwide. J Rehabil Med. 2022;54(3)."},{"issue":"April","key":"i1945-5763-29-3-80-b4","series-title":"Acad Med Sci","first-page":"1","article-title":"Multimorbidity: A priority for global health research","author":"MacMahon\n              S","year":"2018","unstructured":"MacMahon\n              S\n            ; The Academy of Medical Sciences. Multimorbidity: A priority for global health research. Acad Med Sci. 2018;(April):1-127."},{"issue":"12","key":"i1945-5763-29-3-80-b5","series-title":"Spinal Cord","first-page":"882","article-title":"Frequency and age effects of secondary health conditions in individuals with spinal cord injury: A scoping review","volume":"51","author":"Jensen\n              MP","year":"2013","unstructured":"Jensen\n              MP\n            , TruittAR, SchomerKG, YorkstonKM, BaylorC, MoltonIR. Frequency and age effects of secondary health conditions in individuals with spinal cord injury: A scoping review. Spinal Cord. 2013;51(12):882-892."},{"issue":"4","key":"i1945-5763-29-3-80-b6","series-title":"Top Spinal Cord Inj Rehabil","first-page":"289","article-title":"Health care utilization in persons with traumatic spinal cord injury: the importance of multimorbidity and the impact on patient outcomes","volume":"20","author":"Noonan\n              VK","year":"2014","unstructured":"Noonan\n              VK\n            , FallahN, ParkSE, et al.\n          Health care utilization in persons with traumatic spinal cord injury: the importance of multimorbidity and the impact on patient outcomes. Top Spinal Cord Inj Rehabil. 2014;20(4):289-301"},{"issue":"4","key":"i1945-5763-29-3-80-b7","series-title":"Top Spinal Cord Inj Rehabil","first-page":"249","article-title":"The Spinal Cord Injury Community Survey: A national and comprehensive study to portray the life of Canadians with a spinal cord injury","volume":"20","author":"Noreau\n              L","year":"2014","unstructured":"Noreau\n              L\n            , NoonanVK, CobbJ, LeblondJ, DumontFS. The Spinal Cord Injury Community Survey: A national and comprehensive study to portray the life of Canadians with a spinal cord injury. Top Spinal Cord Inj Rehabil. 2014;20(4):249-264."},{"issue":"4","key":"i1945-5763-29-3-80-b8","series-title":"Int Wound J","first-page":"431","article-title":"The average cost of pressure ulcer management in a community dwelling spinal cord injury population","volume":"10","author":"Chan\n              B","year":"2013","unstructured":"Chan\n              B\n            , NanwaN, MittmannN, BryantD, CoyteP, HoughtonP. The average cost of pressure ulcer management in a community dwelling spinal cord injury population. Int Wound J. 2013Aug;10(4):431-440."},{"issue":"3","key":"i1945-5763-29-3-80-b9","series-title":"Chronic Dis Inj Can","first-page":"113","article-title":"The economic burden of traumatic spinal cord injury in Canada","volume":"33","author":"Krueger\n              H","year":"2013","unstructured":"Krueger\n              H\n            , NoonanVK, TrenamanLM, JoshiP, RiversCS. The economic burden of traumatic spinal cord injury in Canada. Chronic Dis Inj Can. 2013;33(3):113-122."},{"issue":"9","key":"i1945-5763-29-3-80-b10","series-title":"Arch Phys Med Rehabil","first-page":"1753","article-title":"Development and assessment of a community follow-up questionnaire for the Rick Hansen Spinal Cord Injury Registry","volume":"94","author":"Noreau\n              L","year":"2013","unstructured":"Noreau\n              L\n            , CobbJ, BelangerLM, DvorakMF, LeblondJ, NoonanVK. Development and assessment of a community follow-up questionnaire for the Rick Hansen Spinal Cord Injury Registry. Arch Phys Med Rehabil. 2013;94(9):1753-1765."},{"issue":"5","key":"i1945-5763-29-3-80-b11","series-title":"J Rehabil Med","first-page":"239","article-title":"Life satisfaction in 18- to 64-year-old Swedes: In relation to gender, age, partner and immigrant status","volume":"34","author":"Fugl-Meyer\n              AR","year":"2002","unstructured":"Fugl-Meyer\n              AR\n            , MelinR, Fugl-MeyerKS. Life satisfaction in 18- to 64-year-old Swedes: In relation to gender, age, partner and immigrant status. J Rehabil Med. 2002;34(5):239-246."},{"key":"i1945-5763-29-3-80-b12","series-title":"Canadian Community Health Survey (CCHS) - Cycle 3.1","author":"Statistic Canada","year":"2005","unstructured":"Statistic Canada\n          . Canadian Community Health Survey (CCHS) - Cycle 3.1. 2005. http:\/\/www23.statcan.gc.ca\/imdb\/p2SV.pl?Function=getSurvey&SurvId=1630&InstaId=22642&SDDS=3226"},{"issue":"9","key":"i1945-5763-29-3-80-b13","series-title":"Patient Educ Couns","first-page":"1046","article-title":"Physician attitudes toward shared decision making: A systematic review","volume":"98","author":"Pollard\n              S","year":"2015","unstructured":"Pollard\n              S\n            , BansbackN, BryanS. Physician attitudes toward shared decision making: A systematic review. Patient Educ Couns. 2015;98(9):1046-57."},{"issue":"8","key":"i1945-5763-29-3-80-b14","series-title":"J Comp Eff Res","first-page":"817","article-title":"Effect of frailty on resource use and cost for Medicare patients","volume":"7","author":"Simpson\n              K","year":"2018","unstructured":"Simpson\n              K\n            , SeamonB, HandB, RoldanC, TaberD, MoranW, SimpsonA. Effect of frailty on resource use and cost for Medicare patients. J Comp Eff Res. 2018;7(8):817-825."},{"issue":"20","key":"i1945-5763-29-3-80-b15","series-title":"J Neurotrauma","first-page":"2892","article-title":"The economic burden of urinary tract infection and pressure ulceration in acute traumatic spinal cord injury admissions: Evidence for comparative economics and decision analytics from a matched case-control study","volume":"34","author":"White\n              B","year":"2017","unstructured":"White\n              B\n            , DeaN, StreetJ, et al.\n          The economic burden of urinary tract infection and pressure ulceration in acute traumatic spinal cord injury admissions: Evidence for comparative economics and decision analytics from a matched case-control study. J Neurotrauma. 2017;34(20):2892-2900."},{"issue":"12","key":"i1945-5763-29-3-80-b16","series-title":"Arch Phys Med Rehabil","first-page":"2279","article-title":"Health care resource utilization and medical costs of spinal cord injury with neuropathic pain in a commercially insured population in the United States","volume":"95","author":"Margolis\n              J","year":"2014","unstructured":"Margolis\n              J\n            , JuneauP, SadoskyA, CappelleriJ, BryceT, NieshoffE. Health care resource utilization and medical costs of spinal cord injury with neuropathic pain in a commercially insured population in the United States. Arch Phys Med Rehabil. 2014;95(12):2279-87."},{"key":"i1945-5763-29-3-80-b1","series-title":"Clin Epidemiol","first-page":"309","article-title":"Global prevalence and incidence of traumatic spinal cord injury","volume":"6","author":"Singh\n              A","year":"2014","unstructured":"Singh\n              A\n            , TetreaultL, Kalsi-RyanS, NouriA, FehlingsMG. Global prevalence and incidence of traumatic spinal cord injury. Clin Epidemiol. 2014;6:309-331."},{"issue":"7","key":"i1945-5763-29-3-80-b2","series-title":"Spinal Cord","first-page":"618","article-title":"Prevalence of comorbidities and secondary health conditions among the Finnish population with spinal cord injury","volume":"60","author":"Tallqvist\n              S","year":"2022","unstructured":"Tallqvist\n              S\n            , KauppilaA-M, Vainionp\u00e4\u00e4A, et al.\n          Prevalence of comorbidities and secondary health conditions among the Finnish population with spinal cord injury. Spinal Cord. 2022;60(7):618-27."},{"issue":"3","key":"i1945-5763-29-3-80-b3","series-title":"J Rehabil Med","article-title":"Physical health conditions in persons with spinal cord injury across 21 countries worldwide","volume":"54","author":"Str\u00f8m\n              V","year":"2022","unstructured":"Str\u00f8m\n              V\n            , M\u00e5numG, AroraM, et al.\n          Physical health conditions in persons with spinal cord injury across 21 countries worldwide. J Rehabil Med. 2022;54(3)."},{"issue":"April","key":"i1945-5763-29-3-80-b4","series-title":"Acad Med Sci","first-page":"1","article-title":"Multimorbidity: A priority for global health research","author":"MacMahon\n              S","year":"2018","unstructured":"MacMahon\n              S\n            ; The Academy of Medical Sciences. Multimorbidity: A priority for global health research. Acad Med Sci. 2018;(April):1-127."},{"issue":"12","key":"i1945-5763-29-3-80-b5","series-title":"Spinal Cord","first-page":"882","article-title":"Frequency and age effects of secondary health conditions in individuals with spinal cord injury: A scoping review","volume":"51","author":"Jensen\n              MP","year":"2013","unstructured":"Jensen\n              MP\n            , TruittAR, SchomerKG, YorkstonKM, BaylorC, MoltonIR. Frequency and age effects of secondary health conditions in individuals with spinal cord injury: A scoping review. Spinal Cord. 2013;51(12):882-892."},{"issue":"4","key":"i1945-5763-29-3-80-b6","series-title":"Top Spinal Cord Inj Rehabil","first-page":"289","article-title":"Health care utilization in persons with traumatic spinal cord injury: the importance of multimorbidity and the impact on patient outcomes","volume":"20","author":"Noonan\n              VK","year":"2014","unstructured":"Noonan\n              VK\n            , FallahN, ParkSE, et al.\n          Health care utilization in persons with traumatic spinal cord injury: the importance of multimorbidity and the impact on patient outcomes. Top Spinal Cord Inj Rehabil. 2014;20(4):289-301"},{"issue":"4","key":"i1945-5763-29-3-80-b7","series-title":"Top Spinal Cord Inj Rehabil","first-page":"249","article-title":"The Spinal Cord Injury Community Survey: A national and comprehensive study to portray the life of Canadians with a spinal cord injury","volume":"20","author":"Noreau\n              L","year":"2014","unstructured":"Noreau\n              L\n            , NoonanVK, CobbJ, LeblondJ, DumontFS. The Spinal Cord Injury Community Survey: A national and comprehensive study to portray the life of Canadians with a spinal cord injury. Top Spinal Cord Inj Rehabil. 2014;20(4):249-264."},{"issue":"4","key":"i1945-5763-29-3-80-b8","series-title":"Int Wound J","first-page":"431","article-title":"The average cost of pressure ulcer management in a community dwelling spinal cord injury population","volume":"10","author":"Chan\n              B","year":"2013","unstructured":"Chan\n              B\n            , NanwaN, MittmannN, BryantD, CoyteP, HoughtonP. The average cost of pressure ulcer management in a community dwelling spinal cord injury population. Int Wound J. 2013Aug;10(4):431-440."},{"issue":"3","key":"i1945-5763-29-3-80-b9","series-title":"Chronic Dis Inj Can","first-page":"113","article-title":"The economic burden of traumatic spinal cord injury in Canada","volume":"33","author":"Krueger\n              H","year":"2013","unstructured":"Krueger\n              H\n            , NoonanVK, TrenamanLM, JoshiP, RiversCS. The economic burden of traumatic spinal cord injury in Canada. Chronic Dis Inj Can. 2013;33(3):113-122."},{"issue":"9","key":"i1945-5763-29-3-80-b10","series-title":"Arch Phys Med Rehabil","first-page":"1753","article-title":"Development and assessment of a community follow-up questionnaire for the Rick Hansen Spinal Cord Injury Registry","volume":"94","author":"Noreau\n              L","year":"2013","unstructured":"Noreau\n              L\n            , CobbJ, BelangerLM, DvorakMF, LeblondJ, NoonanVK. Development and assessment of a community follow-up questionnaire for the Rick Hansen Spinal Cord Injury Registry. Arch Phys Med Rehabil. 2013;94(9):1753-1765."},{"issue":"5","key":"i1945-5763-29-3-80-b11","series-title":"J Rehabil Med","first-page":"239","article-title":"Life satisfaction in 18- to 64-year-old Swedes: In relation to gender, age, partner and immigrant status","volume":"34","author":"Fugl-Meyer\n              AR","year":"2002","unstructured":"Fugl-Meyer\n              AR\n            , MelinR, Fugl-MeyerKS. Life satisfaction in 18- to 64-year-old Swedes: In relation to gender, age, partner and immigrant status. J Rehabil Med. 2002;34(5):239-246."},{"key":"i1945-5763-29-3-80-b12","series-title":"Canadian Community Health Survey (CCHS) - Cycle 3.1","author":"Statistic Canada","year":"2005","unstructured":"Statistic Canada\n          . Canadian Community Health Survey (CCHS) - Cycle 3.1. 2005. http:\/\/www23.statcan.gc.ca\/imdb\/p2SV.pl?Function=getSurvey&SurvId=1630&InstaId=22642&SDDS=3226"},{"issue":"9","key":"i1945-5763-29-3-80-b13","series-title":"Patient Educ Couns","first-page":"1046","article-title":"Physician attitudes toward shared decision making: A systematic review","volume":"98","author":"Pollard\n              S","year":"2015","unstructured":"Pollard\n              S\n            , BansbackN, BryanS. Physician attitudes toward shared decision making: A systematic review. Patient Educ Couns. 2015;98(9):1046-57."},{"issue":"8","key":"i1945-5763-29-3-80-b14","series-title":"J Comp Eff Res","first-page":"817","article-title":"Effect of frailty on resource use and cost for Medicare patients","volume":"7","author":"Simpson\n              K","year":"2018","unstructured":"Simpson\n              K\n            , SeamonB, HandB, RoldanC, TaberD, MoranW, SimpsonA. Effect of frailty on resource use and cost for Medicare patients. J Comp Eff Res. 2018;7(8):817-825."},{"issue":"20","key":"i1945-5763-29-3-80-b15","series-title":"J Neurotrauma","first-page":"2892","article-title":"The economic burden of urinary tract infection and pressure ulceration in acute traumatic spinal cord injury admissions: Evidence for comparative economics and decision analytics from a matched case-control study","volume":"34","author":"White\n              B","year":"2017","unstructured":"White\n              B\n            , DeaN, StreetJ, et al.\n          The economic burden of urinary tract infection and pressure ulceration in acute traumatic spinal cord injury admissions: Evidence for comparative economics and decision analytics from a matched case-control study. J Neurotrauma. 2017;34(20):2892-2900."},{"issue":"12","key":"i1945-5763-29-3-80-b16","series-title":"Arch Phys Med Rehabil","first-page":"2279","article-title":"Health care resource utilization and medical costs of spinal cord injury with neuropathic pain in a commercially insured population in the United States","volume":"95","author":"Margolis\n              J","year":"2014","unstructured":"Margolis\n              J\n            , JuneauP, SadoskyA, CappelleriJ, BryceT, NieshoffE. Health care resource utilization and medical costs of spinal cord injury with neuropathic pain in a commercially insured population in the United States. 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