title: A booming economy means a bursting trauma system: association between hospital admission for major injury and indicators of economic activity in a large Canadian health region.
abstract: BACKGROUND
  Injury epidemiology fluctuates with economic activity in many countries. These relationships remain unclear in Canada.
  
  
  METHODS
  The annual risk of admission for major injury (Injury Severity Score ≥12) to a high-volume, level-1 Canadian trauma center was compared with indicators of economic activity over a 16-year period using linear regression.
  
  
  RESULTS
  An increased risk of injured patient admissions was associated with rising mean gross domestic product (GDP [millions of chained 2002 dollars]) (.36 person increase per 100,000 population/$1,000 increase in GDP; P = .001) and annual gasoline prices (.47 person increase per 100,000 population/cent increase in gasoline price; P = .001). Recreation-related vehicle injuries were also associated with economic affluence. The risk of trauma patient mortality with increasing mean annual GDP (P = .72) and gasoline prices (P = .32) remained unchanged.
  
  
  CONCLUSIONS
  Hospital admissions for major injury, but not trauma patient mortality, were associated with economic activity in a large Canadian health care region.
authors.affiliation: Department of Surgery, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada; Department of Community Health Sciences, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada.
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Roberts
authors.affiliation: Department of Surgery, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada.
authors.forename: Debanjana
authors.initials: D
authors.lastname: Das
authors.affiliation: Department of Regional Trauma Services, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada.
authors.forename: Michelle
authors.initials: M
authors.lastname: Mercado
authors.affiliation: Department of Regional Trauma Services, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Vis
authors.affiliation: Department of Surgery, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada; Department of Regional Trauma Services, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada; Department of Critical Care Medicine, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada.
authors.forename: John B
authors.initials: JB
authors.lastname: Kortbeek
authors.affiliation: Department of Surgery, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada; Department of Regional Trauma Services, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Kirkpatrick
authors.affiliation: Department of Surgery, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada; Department of Regional Trauma Services, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada; Department of Oncology, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada. Electronic address: Ball.Chad@gmail.com.
authors.forename: Chad G
authors.initials: CG
authors.lastname: Ball
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta / Q000453:epidemiology; D004467:Economics / Q000706:statistics & numerical data*; D005260:Female; D059066:Gross Domestic Product / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D061847:Hospitals, High-Volume / Q000706:statistics & numerical data; D006801:Humans; D015601:Injury Severity Score; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012042:Registries; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000191:economics* / Q000453:epidemiology; D055815:Young Adult
keywords: Ecological study; Economic indicators; Major trauma; Wounds and injuries