title: Health-care costs of conservative management of spine fractures in trauma patients.
abstract: There is a lack of evidence on the broad health-care costs of treating spine trauma patients without neurological deficits conservatively. The aim of the present study was to estimate the primary and secondary health-care sector costs associated with conservative treatment of spine fractures as well as their determinants.
  
  
  
  Patients were identified between 1999 and 2008 in the hospital's administrative system based on relevant diagnostic codes. Inclusion criteria were: (1) spine fractures (C1-L5); (2) age >18; and (3) conservative treatment. Exclusion criteria were: (1) neurological involvement and (2) fractures secondary to osteoporosis/malignancy. Health-care utilization and costs were retrieved from national administrative databases covering the entire health-care sector.
  
  
  
  201 cervical, 150 thoracic, and 140 lumbar fracture patients were included in the study. The total health cost was estimated at €18,919 (16,199; 21,756), €8571 (6062; 11,733), €5526 (3473; 7465) for cervical, thoracic, and lumbar regions, respectively. Hospital admissions accounted for the vast majority of costs while primary health care accounted for less than 3 % and prescription medication for less than 2 %. The determinants of costs included fracture site (p < 0.001) and concomitant lower limb injuries (p = 0.009).
  
  
  
  Spinal fractures, even mild ones, appear to incur substantial health-care utilization and costs. Health-care costs in conjunction with cervical fractures are more than two-fold of those affiliated with thoracic and lumbar fractures. Among the concomitant injuries, lower limb injuries exert a substantial influence over health-care costs.
authors: Aarhus University Hospital Orthopedic Spinal Research Laboratory, Noerrebrogade 44, Building 1A, 8000, Aarhus, Denmark. efe_aras2002@yahoo.com.
authors: Efe Levent
authors: EL
authors: Aras
authors: Department of Orthopedic Surgery, Aarhus University Hospital, Aarhus, Denmark.
authors: Cody
authors: C
authors: Bunger
authors: Department of Orthopedic Surgery, Aarhus University Hospital, Aarhus, Denmark.
authors: Ebbe Stender
authors: ES
authors: Hansen
authors: Department of Public Health, Aarhus University, Aarhus, Denmark.|Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
authors: Rikke
authors: R
authors: Søgaard
mesh_terms: D000367:Age Factors; D000553:Ambulatory Care / Q000191:economics; D000072700:Conservative Treatment / Q000191:economics*; D003718:Denmark; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008137:Longitudinal Studies; D035002:Lower Extremity / Q000293:injuries; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000191:economics; D016103:Spinal Fractures / Q000191:economics* / Q000628:therapy
keywords: Conservative treatment; Health-care costs; Health-care utilization; Spine fractures