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METHODS

Cost effectiveness and utility measurements were performed coincidental with a 10 year longitudinal neurogenic protocol in 150 complete SCI (92 male 58 female). Subjects were seen annually at a tertiary care teaching hospital and completed a protocol including video urodynamics, 24 hour creatinine clearance and renal ultrasound according to a standardized follow up protocol. Markov decision models were used to tabulate costs and quality adjusted life years (QUALY's) accumulated in each subject. Unit costs related to physician care and urodynamics were taken from medical services plan reimbursement rates. Comparison was available to 58 SCI subjects who had undergone patient initiated follow up. Data were analyzed in a cost-utility framework from a governmental single payer perspective over the 10 year time horizon including sensitivity analysis.

RESULTS

Patients who underwent annual …