title: Health care utilization and expenditures among Medicaid beneficiaries with neuropathic pain following spinal cord injury.
abstract: BACKGROUND
  The study aimed to evaluate health care resource utilization (HRU) and costs for neuropathic pain (NeP) secondary to spinal cord injury (SCI) among Medicaid beneficiaries.
  
  
  METHODS
  The retrospective longitudinal cohort study used Medicaid beneficiary claims with SCI and evidence of NeP (SCI-NeP cohort) matched with a cohort without NeP (SCI-only cohort). Patients had continuous Medicaid eligibility 6 months pre- and 12 months postindex, defined by either a diagnosis of central NeP (ICD-9-CM code 338.0x) or a pharmacy claim for an NeP-related antiepileptic or antidepressant drug within 12 months following first SCI diagnosis. Demographics, clinical characteristics, HRU, and expenditures were compared between cohorts.
  
  
  RESULTS
  Propensity score-matched cohorts each consisted of 546 patients. Postindex percentages of patients with physician office visits, emergency department visits, SCI- and pain-related procedures, and outpatient prescription utilization were all significantly higher for SCI-NeP (P<0.001). Using regression models to account for covariates, adjusted mean expenditures were US$47,518 for SCI-NeP and US$30,150 for SCI only, yielding incremental costs of US$17,369 (95% confidence interval US$9,753 to US$26,555) for SCI-NeP. Factors significantly associated with increased cost included SCI type, trauma-related SCI, and comorbidity burden.
  
  
  CONCLUSIONS
  Significantly higher HRU and total costs were incurred by Medicaid patients with NeP secondary to SCI compared with matched SCI-only patients.
authors: Truven Health Analytics, Bethesda, MD, USA.
authors: Jay M
authors: JM
authors: Margolis
authors: Truven Health Analytics, Bethesda, MD, USA.
authors: Paul
authors: P
authors: Juneau
authors: Pfizer Inc., New York, NY, USA.
authors: Alesia
authors: A
authors: Sadosky
authors: Pfizer Inc., Groton, CT, USA.
authors: Joseph C
authors: JC
authors: Cappelleri
authors: Department of Rehabilitation Medicine, The Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors: Thomas N
authors: TN
authors: Bryce
authors: Department of Physical Medicine and Rehabilitation, Wayne State University School of Medicine, Detroit, MI, USA.
authors: Edward C
authors: EC
authors: Nieshoff
keywords: burden of illness; spinal cord injuries