title: Healthcare costs and productivity costs of hand and wrist injuries by external cause: A population-based study in working-age adults in the period 2008-2012.
abstract: BACKGROUND
  Hand and wrist injuries are very common at the Emergency Departments (ED), and among the most costly injury types in the working population. The purpose of this study was to explore the causes of non-trivial hand and wrist injuries (i.e., hand fractures, wrist fractures and complex soft-tissue injuries) in working-age adults in order to identify target areas for prevention.
  
  
  METHODS
  Data were extracted from the Dutch Injury Surveillance System, from the National Hospital Discharge Registry and from a patient follow-up survey in working-age adults (aged 20-64 years) in the period 2008-2012. An incidence-based cost model was used to estimate healthcare costs, and an absenteeism model for estimating the productivity costs. Total costs were calculated by external cause, subdivided in their main categories (home, sports, work, traffic and violence) and their most important subclasses.
  
  
  RESULTS
  Total costs of these injuries in The Netherlands were US $410 million per year, of which 75% (US $307 million) productivity costs. Males represented 66% (US $271 million) of the total costs. Within the male group, the group 35-49 years had the highest contribution to total costs (US $112 million), as well as the highest costs per case (US $10,675). Work-related injuries showed the highest costs per case (US $11,797), however, only 25% of the total costs were work-related. The top five causes in terms of total costs were: accidents at home (falls 23%, contact with an object 17%), traffic (cycling 9%) and work (industrial work 4%, and construction work 4%).
  
  
  CONCLUSIONS
  Hand and wrist injuries are a major cause of healthcare and productivity costs in working-age adults. To reduce the costs to society, prevention initiatives should be targeted at major contributing causes, that are mainly related to activities at home (falls, contact with an object) and accidents at the road (cycling).
authors.affiliation: Department of Plastic-, Reconstructive- and Hand Surgery, Erasmus MC, Rotterdam, The Netherlands. Electronic address: ddeputter@gmail.com.
authors.forename: C E
authors.initials: CE
authors.lastname: de Putter
authors.affiliation: Department of Public Health, Erasmus MC, Rotterdam, The Netherlands. Electronic address: e.vanbeeck@erasmusmc.nl.
authors.forename: E F
authors.initials: EF
authors.lastname: van Beeck
authors.affiliation: Department of Public Health, Erasmus MC, Rotterdam, The Netherlands. Electronic address: s.polinder@erasmusmc.nl.
authors.forename: S
authors.initials: S
authors.lastname: Polinder
authors.affiliation: Consumer Safety Institute, Amsterdam, The Netherlands. Electronic address: m.panneman@veiligheid.nl.
authors.forename: M J M
authors.initials: MJ
authors.lastname: Panneman
authors.affiliation: Department of Public Health, Erasmus MC, Rotterdam, The Netherlands. Electronic address: a.burdorf@erasmusmc.nl.
authors.forename: A
authors.initials: A
authors.lastname: Burdorf
authors.affiliation: Department of Plastic-, Reconstructive- and Hand Surgery, Erasmus MC, Rotterdam, The Netherlands. Electronic address: s.e.r.hovius@erasmusmc.nl.
authors.forename: S E R
authors.initials: SE
authors.lastname: Hovius
authors.affiliation: Department of Plastic-, Reconstructive- and Hand Surgery, Erasmus MC, Rotterdam, The Netherlands; Department of Rehabilitation Medicine & Physical Therapy, Erasmus MC, Rotterdam, The Netherlands. Electronic address: r.selles@erasmusmc.nl.
authors.forename: R W
authors.initials: RW
authors.lastname: Selles
mesh_terms: D000041:Absenteeism; D000328:Adult; D017281:Cost of Illness; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006230:Hand Injuries / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D017048:Health Care Costs / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011159:Population Surveillance; D014954:Wrist Injuries / Q000191:economics* / Q000453:epidemiology / Q000628:therapy
keywords: Hand; Injuries; Prevention; Trends; Working-age