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Volume 45 Number 6, 2008
   Pages 695 — 730

Abstract - Major medical conditions and VA healthcare costs near end of life for veterans with spinal cord injuries and disorders

Wei Yu, PhD;1* Bridget Smith, PhD; 2–3 Shirley Kim, MPH; 1 Adam Chow, BA;1 Frances M. Weaver, PhD 2,4

1Health Economics Resource Center, Department of Veterans Affairs (VA) Palo Alto Health Care System, Palo Alto, CA; 2Center for Management of Complex Chronic Care, Spinal Cord Injury Quality Enhancement Research Initiative, Edward Hines Jr VA Hospital, Chicago, IL; 3Institute for Healthcare Studies and 4Department of Neurology,Northwestern University, Chicago, IL

Abstract — We analyzed healthcare costs and medical conditions for 2,008 veterans with spinal cord injuries and disorders(SCI/Ds) near end of life. The average age at SCI/D onset and/or occurrence was 42 years and at death was 66 years. The conditions that incurred the most costs included cancer (20.9%),influenza and/or pneumonia (15.1%), heart disease (13.5%),septicemia (5.9%), diabetes (5.3%), and stroke (5.1%). The average cost was $24,900 in the second year before end of life and reached $61,900 in the final year. Before end of life, costs accelerated during the final year from $3,100 in month 12 to$14,600 in the final month.

Key words: cancer, cause of death, costs, economics, end of life, pneumonia, spinal cord diseases, spinal cord injury, veterans, veterans hospital.

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