title: The NLstart2run study: Economic burden of running-related injuries in novice runners participating in a novice running program.
abstract: OBJECTIVE
  To investigate the economic burden of running-related injuries (RRI) occurred during the 6-week 'Start-to-Run' program of the Dutch Athletics Federation in 2013.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  This was a monetary cost analysis using the data prospectively gathered alongside the RRI registration in the NLstart2run study. RRI data were collected weekly. Cost diaries were applied two and six weeks after the RRI registration to collect data regarding healthcare utilisation (direct costs) and absenteeism from paid and unpaid work (indirect costs). RRI was defined as running-related pain that hampered running ability for three consecutive training sessions.
  
  
  RESULTS
  From the 1696 participants included in the analysis, 185 reported a total of 272 RRIs. A total of 26.1% of the cost data (71 RRIs reported by 50 participants) were missing. Therefore, a multiple imputation procedure was performed. The economic burden (direct plus indirect costs) of RRIs was estimated at €83.22 (95% CI €50.42-€116.02) per RRI, and €13.35 (95% CI €7.07-€19.63) per participant. The direct cost per RRI was €56.93 (95% CI €42.05-€71.81) and the indirect cost per RRI was €26.29 (95% CI €0.00-€54.79). The indirect cost was higher for sudden onset RRIs than for gradual onset RRIs, with a mean difference of €33.92 (95% CI €17.96-€49.87).
  
  
  CONCLUSIONS
  Direct costs of RRIs were 2-fold higher than the indirect costs, and sudden onset RRIs presented higher costs than gradual onset RRIs. The results of this study are important to provide information to public health agencies and policymakers about the economic burden of RRIs in novice runners.
authors.affiliation: Amsterdam Collaboration on Health and Safety in Sports, Department of Public & Occupational Health and the EMGO+ Institute for Health and Care Research, VU University Medical Center, The Netherlands.
authors.forename: Luiz C
authors.initials: LC
authors.lastname: Hespanhol Junior
authors.affiliation: Department of Rehabilitation, Nursing Science & Sport, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, The Netherlands.
authors.forename: Bionka M A
authors.initials: BM
authors.lastname: Huisstede
authors.affiliation: Department of Rehabilitation, Nursing Science & Sport, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, The Netherlands.
authors.forename: Dirk-Wouter
authors.initials: DW
authors.lastname: Smits
authors.affiliation: Center for Sports Medicine, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Bas
authors.initials: B
authors.lastname: Kluitenberg
authors.affiliation: Center for Sports Medicine, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Henk
authors.initials: H
authors.lastname: van der Worp
authors.affiliation: Department of General Practice, Erasmus MC University Medical Center Rotterdam, The Netherlands.
authors.forename: Marienke
authors.initials: M
authors.lastname: van Middelkoop
authors.affiliation: Departments of Epidemiology and Surgery, Research School CAPHRI, Maastricht University Medical Centre+, The Netherlands; Sports Medicine Center Maastricht*Parkstad, The Netherlands.
authors.forename: Fred
authors.initials: F
authors.lastname: Hartgens
authors.affiliation: Amsterdam Collaboration on Health and Safety in Sports, Department of Public & Occupational Health and the EMGO+ Institute for Health and Care Research, VU University Medical Center, The Netherlands; UCT/MRC Research Unit for Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, South Africa; Australian Centre for Research into Injury in Sport and its Prevention, Federation University Australia, Australia. Electronic address: e.verhagen@vumc.nl.
authors.forename: Evert
authors.initials: E
authors.lastname: Verhagen
mesh_terms: D000328:Adult; D001265:Athletic Injuries / Q000191:economics*; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011446:Prospective Studies; D012420:Running / Q000293:injuries*; D011795:Surveys and Questionnaires
keywords: Cohort studies; Costs and cost analysis; Epidemiological monitoring; Epidemiology; Sports injury