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Abstract
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A large number of nonfatal injuries are treated in U.S. emergency departments (EDs) every year. CDC's National Center for Health Statistics estimates that approximately 29% of all ED visits in 2010 were for injuries. To assess the economic impact of ED-treated injuries, CDC examined injury data from the National Electronic Injury Surveillance System–All Injury Program (NEISS-AIP) for 2013, as well as injury-related lifetime medical and work-loss costs from the Web-Based Injury Statistics Query and Reporting System (WISQARS). NEISS-AIP collects data from a nationally representative sample of EDs, using specific guidelines for recording the primary diagnosis and mechanism of injury. Number of injuries, crude- and age-specific injury rates, and total lifetime work-loss costs and medical costs were calculated for ED-treated injuries, stratified by sex, age groups, and intent and mechanism of injury. ED-treated injuries were further classified as those that were subsequently hospitalized or treated and released. The rate of hospitalized injuries was 950.8 per 100,000, and the rate of treated and released injuries was 8,549.8 per 100,000. Combined medical and work-loss costs for all ED-treated injuries (both hospitalized and treated and released) were $456.9 billion, or approximately 68% of the total costs of $671 billion associated with all fatal and ED-treated injuries. The substantial economic burden associated with nonfatal injuries underscores the need for effective prevention strategies.
Numbers of ED-treated injuries, rates, and lifetime cost estimates by age and sex of the patient and by mechanism and intent of injury were analyzed using WISQARS. Rates were calculated using the U.S. Census Bureau's bridged race population estimates for 2013. Lifetime medical and work-loss costs were calculated from average costs of treating nonfatal injuries and earnings in 2010, adjusted to 2013 prices. Lifetime work-loss is the estimated wages lost because of time away from work while recovering from the injury, and the loss of income incurred for injuries that lead to permanent disability. For each ED-treated injury record, lifetime work-loss costs and medical costs were assigned using the age and sex of the injured person, along with the injury diagnosis and mechanism. Work-loss and medical costs for nonfatal injuries were developed from various sources, including days of work missed because of injury, from the Agency for Healthcare Research and Quality's (AHRQ) Medical Expenditure Panel Survey; hospital costs, from the Health Care Cost and Utilization Project; earnings data, from the U.S. Census Bureau's Current Population Survey; and life expectancy data, from CDC's National Center for Health Statistics. Number of injuries, rates, and total lifetime medical and work-loss costs were estimated for 2013, stratified by sex, age and intent of injury. Differences by race and ethnicity were not examined because those data are not available in the WISQARS nonfatal injury reports. The distribution of costs by mechanism of injury and ED discharge disposition of treatment (i.e., hospitalized or treated and released) was also assessed for seven selected mechanisms. Finally, the costs of ED-treated nonfatal injuries were compared with those of fatal injuries presented in another MMWR report.
For all ED-treated nonfatal injuries, the total costs were $456.9 billion; 63% of these costs were for hospitalized injuries, for which the total estimated lifetime medical and work-loss costs were $289.7 billion. Approximately 65% of these costs were accounted for by males; these costs were also concentrated in the adult population, with more than three quarters of the cost being for persons aged ≥25 years. Unintentional injuries accounted for $253.5 billion in lifetime costs, or about 87% of costs for hospitalized injuries. Assault injuries and self-harm injuries (defined as an injury or poisoning resulting from a deliberate violent act inflicted on oneself) accounted for $26.4 billion and $11.3 billion of lifetime costs, respectively. Approximately 85% of costs for hospitalized assault injuries were borne by males ($22.5 billion), whereas costs for hospitalized self-harm injuries were more similar among males ($6.5 billion) and females ($4.7 billion). Costs for hospitalized violent injuries were concentrated among adults aged 15–44 years, with 72% of costs for assaults and 67% of self-harm costs accounted for by these age groups. In contrast, adults aged ≥45 years accounted for 59% of costs associated with hospitalized injuries that were unintentional....
Language: en |