Economic Impact of Hand and Wrist Injuries: Health-Care Costs and Productivity Costs in a Population-Based Study
Economic Impact of Hand and Wrist Injuries: Health-Care Costs and Productivity Costs in a Population-Based Study
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DOI：
10.2106/jbjs.k.00561
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发表时间：
2012-05-02
影响因子：
5.3
通讯作者：
van Beeck, E. F.
中科院分区：
文献类型：
--
作者：
de Putter, C. E.;Selles, R. W.;van Beeck, E. F.
背景：手和手腕损伤约占急诊科就诊患者的20%，可能会造成巨大的经济负担。这项研究的目的是估计手和手腕损伤的总医疗成本和生产力成本，并将其与全国范围内其他重要的伤害群体进行比较。方法：数据来自荷兰伤害监测系统、国家医院出院登记处和2007-2008年间进行的患者随访调查。伤害发生率、医疗保健费用和生产力成本(由于缺勤)按年龄组、性别和不同的伤害亚组计算。基于发病率的成本模型被用来估算伤害的医疗保健成本。结果：手部和手腕损伤每年占7.4亿美元(以美元计算)，在最昂贵的伤害类型中排名第一，排在膝盖和下肢骨折(5.62亿美元)、髋部骨折(5.32亿美元)和颅脑损伤(3.55亿美元)之前。生产力成本对手腕损伤总成本(56%)的贡献率高于直接医疗成本。在所有手腕损伤中，手腕骨折是最昂贵的一组(2.78亿美元)，这主要是由于20-64岁年龄组的高生产力成本(1.92亿美元)。结论：手和手腕损伤不仅是所有治疗创伤的重要组成部分，而且是相当大的经济负担，医疗保健和生产力成本都很高。手和手腕损伤应是创伤护理研究的优先领域，进一步研究有助于降低这些伤害对保健系统和社会的成本。
Background: Injuries to the hand and wrist account for approximately 20% of patient visits to emergency departments and may impose a large economic burden. The purpose of this study was to estimate the total health-care costs and productivity costs of injuries to the hand and wrist and to compare them with other important injury groups in a nationwide study.Methods: Data were retrieved from the Dutch Injury Surveillance System, from the National Hospital Discharge Registry, and from a patient follow-up survey conducted between 2007 and 2008. Injury incidence, health-care costs, and productivity costs (due to absenteeism) were calculated by age group, sex, and different subgroups of injuries. An incidence-based cost model was used to estimate the health-care costs of injuries. Follow-up data on return to work rates were incorporated into the absenteeism model for estimating the productivity costs.Results: Hand and wrist injuries annually account for $740 million (in U.S. dollars) and rank first in the order of most expensive injury types, before knee and lower limb fractures ($562 million), hip fractures ($532 million), and skull-brain injury ($355 million). Productivity costs contributed more to the total costs of hand and wrist injuries (56%) than did direct health-care costs. Within the overall group of hand and wrist injuries, hand and finger fractures are the most expensive group ($278 million), largely due to high productivity costs in the age group of twenty to sixty-four years ($192 million).Conclusions: Hand and wrist injuries not only constitute a substantial part of all treated injuries but also represent a considerable economic burden, with both high health-care and productivity costs. Hand and wrist injuries should be a priority area for research in trauma care, and further research could help to reduce the cost of these injuries, both to the health-care system and to society.