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The European Journal of Public Health Advance Access originally published online on February 13, 2006
The European Journal of Public Health 2006 16(3):271-277; doi:10.1093/eurpub/ckl006
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© The Author 2006. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Injuries

Incidence and costs of injuries in The Netherlands

Willem Jan Meerding1, Saakje Mulder2 and Ed F. van Beeck1

1 Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
2 Consumer Safety Institute, Amsterdam, The Netherlands

Correspondence: Willem Jan Meerding, Department of Public Health, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, The Netherlands, tel: +31 10 408 7954/7714, fax: +31 10 408 9449, e-mail: w.meerding{at}erasmusmc.nl

Background: Injuries are a major and persistent public health problem, but a comprehensive and detailed overview of the economic burden is missing. We therefore estimated the number of emergency department (ED) attendances and health care costs as a result of injury. Methods: We estimated lifetime health care costs of injuries occurring in The Netherlands in the year 1999. Patient groups were defined that are homogeneous in terms of health service use. Health service use and costs per patient group was estimated with data from national databases and a prospective study among 5755 injury patients. Results: Total health care costs due to injury in 1999 were {euro}1.15 billion, or 3.7% of the total health care budget. Major cost peaks were observed among males between ages 15 and 44 due to a high incidence, and among females from age 65 onwards due to a high incidence and high costs per patient. For the age groups 0–14, 15–44, 45–64, and 65+ ED attendances per 1000 person years were 85, 85, 43, and 49, respectively, and costs per capita were {euro}38, {euro}59, {euro}43, and {euro}210, respectively. Costs per patient rise about linearly up to age 60 and about exponentially thereafter. From age 25 onwards, females have higher costs per patient than males. Hip fracture (20%), superficial injury (13%), open wounds (7%), and skull–brain injury (6%) had the highest total costs. Most costs were attributable to falls (44%) and traffic injuries (19%). Conclusion: Young adult males, elderly females, falls, hip fractures, and minor injuries without medical need for hospitalization account for a substantial share of health care costs.

Keywords: emergency service, health care costs, hospitalization, incidence, wounds and injuries


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