title: Prospective study of patients with injuries to the hand and forearm: costs, function, and general health.
abstract: Patients with injured hands and forearms of varying severity [Hand Injury Severity Score (HISS)] were studied prospectively, including analysis of costs, hand/arm function (DASH), and health status (SF-36). Costs, duration of sick-leave, DASH-score (high score; impaired function) increased by severity of injury (higher HISS) and the greatest proportion of total costs resulted from lost production. Most employed patients returned to work within a year, but even minor injuries were expensive. HISS and costs of care during an emergency were significantly associated with duration of sick-leave, although HISS did not fully explain variation in costs and duration of sick-leave. DASH-score at one year was associated with variation in age, HISS, and residual health care costs. Results of DASH and subgroups for physical and bodily pain on SF-36 were consistent. Injuries to hand and forearm may generate high costs for society in terms of health care and long periods of sick-leave (lost production), but even minor injuries should be accounted for.
authors.affiliation: Department of Hand Surgery, Malmö University Hospital, Malmö, Sweden. HansE.Rosberg@med.lu.se
authors.forename: Hans-Eric
authors.initials: HE
authors.lastname: Rosberg
authors.forename: Katarina Steen
authors.initials: KS
authors.lastname: Carlsson
authors.forename: Lars B
authors.initials: LB
authors.lastname: Dahlin
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D005543:Forearm Injuries / Q000191:economics* / Q000453:epidemiology*; D050723:Fractures, Bone / Q000453:epidemiology; D006230:Hand Injuries / Q000191:economics* / Q000453:epidemiology*; D017048:Health Care Costs / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D015601:Injury Severity Score; D007899:Leisure Activities; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012044:Regression Analysis; D018582:Sick Leave / Q000191:economics / Q000706:statistics & numerical data; D013548:Sweden / Q000453:epidemiology