title: The economic burden of injury: Health care and productivity costs of injuries in the Netherlands.
abstract: BACKGROUND
  Detailed information on health care costs and productivity costs for the whole spectrum of injuries is lacking. We measured the total costs of injuries by external-cause, injury groupings, age and sex.
  
  
  METHODS
  Injury patients visiting an Emergency Department in the Netherlands were included. Health service use and work absenteeism were estimated with national database data and a prospective follow-up study. Health care costs (direct costs) and productivity costs (indirect costs) were determined using the incidence-based Dutch Cost of Injury Model.
  
  
  RESULTS
  Total costs of injuries were €3.5 billion annually (€210/capita and €4300/patient); €2.0 billion healthcare costs and €1.5 billion productivity costs. Home and leisure injury subcategory falls caused 41% of total costs. Traffic injury was prominent in the 15-54 age group, mainly due to bicycle injuries. Sports injuries, in special football/soccer injuries, resulted in high costs in the 15-24 age group. Although costs per patient were comparable between males and females, health care costs were higher in females, whereas males have more than twice as high productivity costs. Health care costs were highest for hip fractures (€20,000/patient). Extremity fractures had high costs due to high incidences and high productivity costs per patient.
  
  
  CONCLUSIONS
  Our detailed cost model identified known risk groups, such as elderly females with hip fractures resulting from falls, as well as less obvious important high risk groups, such as young children falling from furniture, young males who sustained football/soccer injuries and bicycle injuries among all ages. This information is essential to assess additional priority areas for prevention.
authors.affiliation: Erasmus MC, Department of Public Health, PO Box 2040, 3000CA Rotterdam, The Netherlands. Electronic address: s.polinder@erasmusmc.nl.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Polinder
authors.affiliation: Erasmus MC, Department of Public Health, PO Box 2040, 3000CA Rotterdam, The Netherlands.
authors.forename: Juanita
authors.initials: J
authors.lastname: Haagsma
authors.affiliation: Consumer Safety Institute, Amsterdam, The Netherlands.
authors.forename: Martien
authors.initials: M
authors.lastname: Panneman
authors.affiliation: Erasmus MC, Department of Public Health, PO Box 2040, 3000CA Rotterdam, The Netherlands.
authors.forename: Annemieke
authors.initials: A
authors.lastname: Scholten
authors.affiliation: Consumer Safety Institute, Amsterdam, The Netherlands.
authors.forename: Marco
authors.initials: M
authors.lastname: Brugmans
authors.affiliation: Erasmus MC, Department of Public Health, PO Box 2040, 3000CA Rotterdam, The Netherlands.
authors.forename: Ed
authors.initials: E
authors.lastname: Van Beeck
mesh_terms: D000058:Accidental Falls / Q000191:economics*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001265:Athletic Injuries / Q000191:economics*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies; D012737:Sex Factors; D014947:Wounds and Injuries / Q000191:economics*; D055815:Young Adult
keywords: External cause; Health care costs; Injury; Productivity costs; Total costs