title: Health, social, and economic consequences of neck injuries: a controlled national study evaluating societal effects on patients and their partners.
abstract: METHODS
  National register-based matched case-control study.
  
  
  OBJECTIVE
  The aim of this study was to estimate the direct and indirect costs of neck injuries, except fractures, in a national sample of patients and their spouses.
  
  
  BACKGROUND
  Despite neck injuries causing significant socioeconomic burdens, there is insufficient information about the time course, as well as the effect on their spouses.
  
  
  METHODS
  Using records from the Danish National Patient Registry 1998-2009, all patients with a diagnosis of neck injury and their spouses were identified and compared with randomly chosen controls matched for age, sex, geographical area, and civil status. Direct costs included frequency of primary and hospital sector contacts and procedures and medication. Indirect costs included the effect on labor supply. Social transfer payments were included to illustrate the effect on national accounts. All cost data were extracted from national databases.
  
  
  RESULTS
  The register contributed 94,224 patients, and 372,341 matched controls were identified. The percentages of married or cohabiting individuals were approximately 47.5% in both groups. Patients with neck injury had significantly higher rates of health-related contacts, medication use, and higher socioeconomic costs than controls. To a lesser extent, they also had lower employment rates, and those employed generally had lower incomes. Furthermore, the patients had already presented negative social- and health-related status up to 11 years before the first diagnosis, which became more pronounced for those with the highest costs. The health effects on costs were present regardless of age group and sex, and it was also seen for the patients' spouses.
  
  
  CONCLUSIONS
  Neck injuries are associated with major socioeconomic consequences for patients, their spouses, and the society. However, the increased expenses during subsequent years cannot be explained by the injury alone, because these patients already had elevated expenses prior to the injury. This indicates some selection of increased vulnerability for both patients and their spouses.
authors.affiliation: Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Glostrup Hospital, Copenhagen, Denmark. poje@regionh.dk
authors.forename: Poul
authors.initials: P
authors.lastname: Jennum
authors.forename: Jakob
authors.initials: J
authors.lastname: Kjellberg
authors.forename: Rikke
authors.initials: R
authors.lastname: Ibsen
authors.forename: Tom
authors.initials: T
authors.lastname: Bendix
mesh_terms: D000041:Absenteeism; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015897:Comorbidity; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D003718:Denmark / Q000453:epidemiology; D016527:Drug Costs; D004651:Employment / Q000191:economics; D005260:Female; D017048:Health Care Costs; D005102:Health Expenditures; D006304:Health Status; D017721:Hospital Costs; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000191:economics* / Q000453:epidemiology / Q000523:psychology; D012042:Registries; D018582:Sick Leave / Q000191:economics; D012943:Social Security / Q000191:economics; D018454:Spouses / Q000523:psychology*; D013997:Time Factors; D055815:Young Adult