Changing Case‐Mix and Inpatient Rehabilitation Costs in C4/C5 Traumatic Cervical Spinal Cord Injury: A 10‐Year Single‐Center Study From a National Rehabilitation Center in China
4 affiliations
- 1Department of Respiratory and Critical Care Medicine Beijing Bo'ai Hospital, China Rehabilitation Research Center Beijing China
- 2School of Rehabilitation Capital Medical University Beijing China
- 3Neurocritical Medicine Department Shanxi Cardiovascular Hospital Taiyuan Shanxi China
- 4Department of Rehabilitation Medicine Peking University Third Hospital Beijing China
Abstract
Background: The case‐mix and inpatient rehabilitation costs of traumatic cervical spinal cord injury (TCSCI) may have shifted with population aging and the coronavirus disease 2019 (COVID‐19) pandemic. We examined decade‐long trends in patient characteristics, injury mechanisms, and per‐diem rehabilitation costs for neurological‐level C4/C5 TCSCI.
Methods: All patients with C4/C5 TCSCI admitted to the China Rehabilitation Research Center were studied retrospectively, comparing 2013–2017 with 2018–2022, and, in an exploratory analysis, the pre‐pandemic (2018–2019) with the pandemic (2020–2022) period. Costs were adjusted for inflation using the medical services Consumer Price Index. Comparisons used the χ 2, Wilcoxon rank‐sum, and Kruskal–Wallis tests. Cost drivers were modeled using multivariable Gamma generalized linear models (log link).
Results: Among 1063 patients (male‐to‐female ratio 5.3:1), mean age rose from 43.9 to 49.5 years and the proportion injured by low‐level falls increased from 20.7% to 33.8% (χ 2 = 37.76, p < 0.001). Length of stay decreased (Z = −2.33, p = 0.02) while adjusted daily cost increased (Z = −10.07, p < 0.001; median 1330 RMB, interquartile range 908–1780, [USD 215]). In constant 2013 prices a real increase persisted (+12.5%, p < 0.001), and the later period remained independently associated with higher daily cost after case‐mix adjustment (adjusted cost ratio 1.15, 95% CI 1.07–1.24).
Conclusions: Admitted patients were increasingly older and frequently injured in low‐level falls. Per‐diem rehabilitation costs rose despite shorter hospital stays. Changes spanning the pandemic represent an exploratory temporal association rather than causal evidence. Fall prevention strategies for older adults and capacity planning for higher‐dependency rehabilitation are warranted.
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BibTeX
@article{li2026changing,
title = {{Changing Case‐Mix and Inpatient Rehabilitation Costs in C4/C5 Traumatic Cervical Spinal Cord Injury: A 10‐Year Single‐Center Study From a National Rehabilitation Center in China}},
author = {Juan Li and Wei Gao and Feng Yang and Xuan Gao and Yiming Zhang and Qing Wang and Lianjun Gao},
journal = {Chronic Diseases and Translational Medicine},
year = {2026},
month = oct,
doi = {10.1002/cdt3.70073},
url = {https://doi.org/10.1002/cdt3.70073},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Changing Case‐Mix and Inpatient Rehabilitation Costs in C4/C5 Traumatic Cervical Spinal Cord Injury: A 10‐Year Single‐Center Study From a National Rehabilitation Center in China
AU - Juan Li
AU - Wei Gao
AU - Feng Yang
AU - Xuan Gao
AU - Yiming Zhang
AU - Qing Wang
AU - Lianjun Gao
PY - 2026
DA - 2026/10/25
JO - Chronic Diseases and Translational Medicine
DO - 10.1002/cdt3.70073
UR - https://doi.org/10.1002/cdt3.70073
AB - Background: The case‐mix and inpatient rehabilitation costs of traumatic cervical spinal cord injury (TCSCI) may have shifted with population aging and the coronavirus disease 2019 (COVID‐19) pandemic. We examined decade‐long trends in patient characteristics, injury mechanisms, and per‐diem rehabilitation costs for neurological‐level C4/C5 TCSCI. Methods: All patients with C4/C5 TCSCI admitted to the China Rehabilitation Research Center were studied retrospectively, comparing 2013–2017 with 2018–2022, and, in an exploratory analysis, the pre‐pandemic (2018–2019) with the pandemic (2020–2022) period. Costs were adjusted for inflation using the medical services Consumer Price Index. Comparisons used the χ 2, Wilcoxon rank‐sum, and Kruskal–Wallis tests. Cost drivers were modeled using multivariable Gamma generalized linear models (log link). Results: Among 1063 patients (male‐to‐female ratio 5.3:1), mean age rose from 43.9 to 49.5 years and the proportion injured by low‐level falls increased from 20.7% to 33.8% (χ 2 = 37.76, p < 0.001). Length of stay decreased (Z = −2.33, p = 0.02) while adjusted daily cost increased (Z = −10.07, p < 0.001; median 1330 RMB, interquartile range 908–1780, [USD 215]). In constant 2013 prices a real increase persisted (+12.5%, p < 0.001), and the later period remained independently associated with higher daily cost after case‐mix adjustment (adjusted cost ratio 1.15, 95% CI 1.07–1.24). Conclusions: Admitted patients were increasingly older and frequently injured in low‐level falls. Per‐diem rehabilitation costs rose despite shorter hospital stays. Changes spanning the pandemic represent an exploratory temporal association rather than causal evidence. Fall prevention strategies for older adults and capacity planning for higher‐dependency rehabilitation are warranted.
SN - 2095-882X
SN - 2589-0514
ER -