In this issue

The Cost of Unintentional Injury

Errata / Staff Changes at CHIRPP / New on the Web Site / SMARTRISK

Safe Communities: The Way of the Future

The Need for Minimum Dataset Injury Surveillance in Canada

Towards 2002

THE CHIRPP SAMPLER - Injuries Associated with Car Doors and Windows

Welcome to CHIRPP News

Issue 16

April 1999

The Cost of Unintentional Injury

by Margaret Herbert
Chief, Child Injury Division

In November 1998, an important and long-awaited report on the cost of injury was released. The Economic Burden of Unintentional Injury in Canada estimates that the total annual cost of unintentional injuries in Canada is $8.7 billion dollars. More than $4.2 billion of the total is in direct cost to the health care system and approximately $4.5 billion is the indirect cost of loss of productivity due to impairment, disability and premature death.

The report makes a strong plea to Canadians for better recognition of the injury problem, more understanding of the risks and awareness of the advantages of preventive action. The report is presented by SMARTRISK, in partnership with the Emergency Health Services Branch of the Ontario Ministry of Health; the Kingston, Frontenac, and Lennox & Addington Health Unit; the Childhood and Youth Division and the Child Injury Division of Health Canada. The Hygeia Group conducted the study which formed the basis of the report.

The project started in 1996 in response to frequent requests for, and mounting frustration at the lack of reliable information on, the real costs of injury in Canada. The partnership group formed, decided to focus on unintentional injuries and requested proposals from research groups involved in health economics. The Hygeia Group was awarded the contract and started work on the project.

The study started with a thorough search of the international literature for studies on the cost of injury and the final report includes a summary of that review. The research team developed an intricate computer model to estimate the total lifetime costs of all injuries to Canadians that occurred in a single year. Data fed into the model include number of injury deaths and hospitalizations by type of injury and nature of injury, the population of Canada by age and sex, costs of hospitalization, costs of medical procedures, and much more. The model estimates many factors, such as the future losses in lifetime earnings for premature death and disability. The completed model was used to generate the results of the study. It estimates overall annual cost of injury, identifies the direct medical costs and indirect costs, and assesses the costs associated with different types of injury, different age groups in the population and different sub-populations in Canada.

The methods used and the costs estimated in this report are very conservative. The model cannot accommodate costs of services, special equipment, and other hidden costs that are not systematically accounted for in some way. For example, it does not include costs of attendant care outside the medical system, structural renovation to accommodate disability, occupational retraining, or loss of income to family members involved in caregiving, and it does not include the enormous insurance costs associated with property damage and loss. Also, the report does not attempt to place any dollar value on the human suffering of injured Canadians and their families. It is clear that in societal terms annual costs related to unintentional injury in Canada far exceed $8.7 billion.

In order to express the results in a meaningful way, the research group presented three scenarios for different types of injury and projected the cost savings associated with reasonable targets for injury reduction. The study shows that, of the $2.4 billion in direct health care costs for falls, $980 million is for those 65 years of age or older. This amount is expected to increase substantially in future years as the Canadian population ages. If intervention programs that effectively reduce the risk factors could reduce the hospitalizations due to falls in seniors by 20% then overall savings could reach $138 million annually.

Falls among children are estimated to cost $630 million each year. A reduction of 20% of these falls in children 0-9 years of age would result in 1,500 fewer admissions to hospital, 13,000 fewer non-hospitalized injuries and overall savings of $126 million each year.

Motor vehicle crashes are a leading cause of injury death, disability and hospitalization. The report estimates that a combined intervention strategy that involves buckling up, driving sober, marginal speed reductions and improved roadway design and maintenance could result in net savings of more than $500 million each year.

The total cost of unintentional injuries, $8.7 billion, is made up of a combination of direct medical costs, $4.2 billion, and indirect costs, $4.5 billion. Three types of injuries, falls, motor vehicle crashes and poisoning account for 70% of direct costs. While only 6% of all injured persons are admitted to hospital, they accrue 23% of direct medical expenses. The 94% of non-admitted (less severe) injuries account for 77% of direct medical costs. Motor vehicle crashes and falls account for 32% of indirect costs. Sixty percent of the indirect costs involved loss of productivity for those suffering permanent disability and 40% were productivity losses caused by premature death due to injury.

The report concludes by recommending that Canada adopt a national injury prevention strategy. Such a strategy would be based on strong leadership and effective collaboration among injury prevention groups. The report proposes that the national strategy incorporate three main com-ponents: comprehensive programming, an expanded national injury surveillance system, and increased support for research.

The summary report of the Economic Burden of Unintentional Injury in Canada is posted on the web site of the Child Injury Division at http://www.hc-sc.gc.ca/hpb/lcdc/brch/injury.html and there is a direct hotlink to the web site of SMARTRISK http://www.smartrisk.ca that posts both the summary and the full report.

[Table of Contents] [Next]