Table 1.

Characteristics of Included Studies.

Study	Country, time-frame	Study type	Participants	Participants data source	Participants identification	Source of cost data	Costing approach	Details on cost items
New and Jackson 2010	Australia 2003-2004	Retro. Cohort	564 (170 traumatic and 394 nontraumatic)	Database from public hospitals included in the Victorian Cost Weights Study	ICD-10-AM	Victorian Department of Human Services (VDHS) costing database	Top-down, Diagnosis-Related Group	Medical, nursing, allied health, and pharmacy
Vaikuntam et al, 2019	Australia 2013-2016	Retro. Cohort	534 ≥ 16 year-olds with acute TSC	NSW Admitted Patient Data Collection (APDC) and Emergency Department Data Collection	ICD-10-AM	NSW Activity-based Funding District Network Return Data	Bottom-up, Activity-based	Costs incurred by health service providers, except staff salaries and operation costs, for all emergency department (ED) and admitted hospital separations
Dryden et al, 2004	Canada 1992-1994	Retro. Cohort	233 with TSCI	Alberta Health Care Insurance Stakeholder Registry	ICD-9-CM	Cost List for Manitoba Health Services (adjusted for Alberta which provides an average cost per day for each RDRG, and Claims database	Top-down, Diagnosis Related Group, and actual costs of physician services abstracted from the Claims database	Hospitalizations, physician services, home care services, long-term admissions, and occurrence of secondary complications. The initial hospitalization included acute care hospitalization and inpatient rehabilitation.
Bradbury et al, 2008	Canada NS	Retro. Cohort	10 SCI without traumatic brain injury	Spinal Cord Rehabilitation Program of Toronto Rehabilitation Institute	NS	Hospital records	Top-down Resource Utilization Group (RUG) (based on FIM)	Clinician workload, nursing, physiotherapy, occupational therapy, rehabilitation therapy, and speech language pathology
Mac-Thiong et al, 2012	Canada 2000-2011	Retro. Cohort	477 with TSCI	Quebec Trauma Registry	ICD-9-CM	Quebec Trauma Registry and Niveau Intensité Relative des Ressources Utilisées index (NIRRU1)	Top-down, Diagnosis Related Group (based on NIRRU)	All resources related to hospitalization.
Munce et al, 2013	Canada 2003-2004 & 2005-2006	Retro. Cohort	559 with TSCI	Rick Hansen Foundation database	ICD-10	Resource intensity weight and provincial average cost from Ontario Ministry of Health and Long-Term Care (MOHLTC), and patients discharge abstracts	Top-down, Diagnosis Related Group	Acute inpatient, ED, hospital rehabilitation, complex continuing care1, home health care services, and physician but not medication costs
Radhakrishna et al, 2014	Canada 1997-2007	Retro. Cohort	481 who sustained SCI from motor vehicle accident	Quebec Trauma Registry (RTQ2)	Using the terms spinal cord injury and motor vehicle collisions	Quebec Medical Insurance Agency (RAMQ3), and Quebec Provincial Automobile Insurer (SAAQ4)	Top-down, Per-diem Quebec hospital cost	Initial hospitalization (including therapy, imaging, medication, surgery, and the hospitals fixed costs), practitioners fees, medications, environmental modifications, and personal aides
Richard-Denis et al 2017	Canada 2008-2014	Retro. Cohort	116 with motor-complete (AIS A, B) cervical SCI	Individuals admitted to a level I SCI-specialized trauma center	–	Hospital database and Niveau Intensité Relative des Ressources Utilisées index (NIRRU)	Top-down, Diagnosis Related Group (based on NIRRU)	The NIRRU index includes all resources related to hospitalization. Physician fee and costs related to the spine surgery and tracheostomy placement were not available.
Porgo et al, 2019	Canada 2019	Retro. Cohort	614 ≥ 16-year-olds admitted to adult trauma centers	Quebec trauma registry	–	Hospital financial reports (AS-471) for the 2016 fiscal year	Bottom-up Activity-based	Non-physician personnel, services and materials costs in ED, medical ward, OR, ICU, imaging, and para-clinical services. drugs, laboratory tests, blood products, and physician fees were not included
Li et al, 2011	China 2002	Retro. Cohort	710 with TSCI	Information Center of Beijing Health Bureau	Using the term paraplegia or tetraplegia in Chinese language	Information Center of Beijing Health Bureau	Top-down	NS
Jiménez-Avila et al, 2012	Mexico 2004-2007	Retro. Cohort	34 ≥ 16-year-olds with complete cervical SCI	Individuals with a diagnosis of complete cervical spinal cord injury	–	Hospital records	Bottom-up (charges)	The cost calculation was done considering bed days, specialty consultation, laboratory, X-ray, axial computed tomography, MRI, and surgery.
Kawu et al, 2011	Nigeria 2009	Pros. Cohort	34 cases with SCI	Spinal cord injured adults at the University of Abuja Hospital	–	Hospital bills paid on discharge	Bottom-up (charges)	Nursing/medical care, accommodation, bed fees, drugs, laboratory charges and operative procedures; But not hospital staff and physicians fees, and medical equipment costs
Tsai et al, 2005	Taiwan 1998-2000	Retro. Cohort	184 with cervical SCI	Bureau of National Health Insurance (BNHI) database	ICD-9-CM	Annual in-patient expenses information system of the BNHI	Top-down	Total in-patient and medical order items
Yang et al, 2008	Taiwan 2000-2003	Retro. Cohort	15,510 with acute TSCI	National Health Insurance (NHI) database	ICD-9-CM	National Health Insurance Bureau (NHIB) datasets, including monthly claim summary for inpatient claims, inpatient expenditures by admissions and details of inpatient orders	Top-down	The datasets including details of inpatient orders, monthly claim summary for inpatient claims and inpatient expenditures by admissions were selected.
Lessing et al, 2020	Tanzania 2016-2019	Retro. Cohort	125 > 14 year-olds	Muhimbili Orthopaedic Institute database	–	Hospital records	Bottom-up Activity-based	The sum of direct costs during admission. For nonoperative patients calculated by adding the cost of initial imaging, LOS, OR fee, surgical implants, and postop. imaging
Price et al, 1994	USA 1989	Retro. Cohort	376 with TSCI	Population-based statewide surveillance system	ICD-9-CM	Estimated or actual charges for acute care and rehabilitation hospitalization	Bottom-up (charges)	All charges of acute care and rehabilitation except physician services, outpatient rehabilitation, emergency transportation and later admissions
Johnson et al, 1996	USA 1989	Retro. Cohort	115 with TSCI	Colorado Spinal Cord Injury Early Notification System (ENS)	ICD-9	Participants were asked about the names of all providers and billing information was obtained from providers.	Bottom-up (hospital or outpatient charges)	Medical services, medical supplies and equipment, in-home care, and the names of providers. Providers are asked for Billing information
Chan et al, 1997	USA 1987-1994	Retro. Cohort	NS, discharges from rehab hospitals (non-acute rehab)	Medicare billing records and selected hospital cost reports	–	Records of hospital charges on Medicare	Bottom-up (charges)	NS
Cifu et al, 1999	USA, 1988-1996	Retro. Cohort	2,099 adults with tetraplegia TSCI	National Model Spinal Cord Injury Systems program	Individuals with paraplegia SCI	Hospital billing records	Bottom-up (estimated or actual hospital bills)	Acute care and inpatient rehabilitation
Cifu et al, 1999	USA 1988-1996	Retro. Cohort	2,169 adult persons with paraplegia TSCI	National Model Spinal Cord Injury Systems program	Individuals with paraplegia SCI	Hospital billing records	Bottom-up Activity-based (estimated or actual hospital charges)	Acute care and inpatient rehabilitation
McKinley et al, 2001	USA 1992-1999	Retro. Cohort	172 rehabilitation inpatients (86 with TSCI and 86 nontraumatic SCI)	National Model Spinal Cord Injury Systems program compiled on the NIDRR7 SCI Database	NS	Actual rehabilitation hospital charges for each patient	Bottom-up (charges)	Nursing, occupational therapy, physiatry and related medical services, physical therapy, psychologic and neurologic assessment, recreational therapy, and social services
Seel et al, 2001	USA 1988-1998	Retro. Cohort	180 adults with paraplegia	National Model Spinal Cord Injury Systems program compiled on the NIDRR5 SCI Database	–	Actual hospital charges for each patient	Bottom-up (charges)
Smith et al, 2003	USA 1993-1999	Retro. Cohort	47 with SCI Caused by Gunshot wounds	National Rehabilitation Hospital	Nonacute rehabilitative care recipients	Completed bills for 12 of the 47 persons	Bottom-up (rehabilitation hospital charges)	NS
Webster et al, 2004	USA 1989-1999	Retro. Cohort	62 with work-related tetraplegia	The workers compensation database	Cross-referencing NCCI codes specific to: body part injured and injury type with relevant word search terms in the accident description	Compensation insurer data source covering 8-10% of the US private workers compensation market	Top-down	Initial hospitalization, acute rehabilitation, subsequent hospital and rehabilitation readmissions, outpatient services (i.e., physician and therapy visits, diagnostic services), pharmacy and medical supplies, vehicle and home modifications, personal care attendants, and ambulance/assisted transportation.
French et al, 2007	USA 2005	Retro. Cohort	675 veterans with SCI	Veterans Health Administration (VHA) administrative database	Non-ventilator dependent wheelchair user veterans with SCI over 2 years	The Decision Support System National Data Extracts (DSS-NDE)	Bottom-up Activity-based (DSS provided costs)	All outpatient and inpatient care i.e. hospitalization and surgery, medications, radiology, laboratory, nursing care, prosthetics, rehabilitation, and nursing home care
Yu et al, 2008	USA 1999-2001	Retro. Cohort	1,181 veterans with SC	VA National Patient Care Databases (NPCDs)	ICD-9	VA Health Economics Resource Center Average Cost File (ACF)	Top-down Medicare’s Diagnosis Related Group	Inpatient and outpatient care at VA facilities
DeVivo et al, 2011	USA 2000-2006	Retro. Cohort	1,676 with SCI	National SCI Statistical Center (NSCISC) database	A random sample of 508 treated from 1973 to 1988 and 227 newly injured in 1989	Charges reflect the average amount billed to individuals or third parties	Bottom-up	Inpatient acute care and rehabilitation, emergency medical services, nursing home, outpatient services, physician fees, equipment, environmental modifications, medications, supplies, attendant care, vocational rehabilitation
Deutsch et al, 2011	USA 2002-2006	Retro. Cohort	2919 > 64 Medicare fee-for-service cases	Medicare claims and assessment data files	ICD-9-CM	Patient-level Medicare billing (ie, claims) records (Medicare Provider Analysis and Review file)	Top-down (The total amount paid to the rehabilitation hospital)	Part A services
Krause et al, 2019	USA 2011-2015	Retro. Cohort	303	State-wide SCI Surveillance System Registry	ICD-9-CM	South Carolina Revenue and Fiscal Affairs, Health and Demographics records	Bottom-up (acute hospital care charges)	Costs related to health care utilization for ED visits and hospitalizations.
Sikka et al, 2019	USA, 2003-2014	Retro. Cohort	591 with TSCI	Trauma registry data merged with the regional hospital registry database (DFWHC)6	ICD-9	DFWHC database	Bottom-up (acute hospital care charges)	NS

1 Niveau Intensité Relative des Ressources Utilisées index (NIRRU); relative intensity of resources, 2 Registre des traumatismes du Québec, 3 Régie de l’assurance maladie du Québec, 4 Société de l’assurance automobile du Québec, 5 National Institute on Disability, Independent Living and Rehabilitation Research (NIDRR), 6 Dallas-Fort Worth Hospital Council.