The incidence and economic burden of injuries in Jiangxi, China

Hospitalization costs of road traffic injuries in Hunan, China: A quantile regression analysis

BACKGROUND

Healthcare expenditure of road traffic injuries in China has not been adequately investigated so far. We aim to provide comprehensive information about the hospitalization costs of inpatients who suffered road traffic injuries, and explore the components and influencing factors of costs.

METHODS

We extracted the data of all inpatients (n = 60535) with road traffic injuries during the year 2019 from Chinese National Health Statistics Network Reporting System database in Hunan, China. We calculated the components of hospitalization costs and analyzed the association between hospitalization costs and patient characteristics using quantile regression models.

RESULTS

The median hospitalization cost was $853.48, and the median length of hospital stay was 9 days. Vulnerable road users accounted for 84.9 % of all cases. Medicine cost is the first driver of hospitalization cost, accounting for 25.94 %. In the low- and medium-cost groups, hospitalization costs were highly concentrated on diagnosis, medicine, and medical services, while in the high-cost groups, consumable cost constituted the highest percentage. Male, a longer length of stay, more severe injuries, two or more comorbidities, surgical treatment, and admission to tertiary hospitals were significantly associated with higher hospitalization costs, and the regression coefficients increased with increasing of quartile points. Costs were lower in the 0-14 years group than in the other groups across all quartiles. At the median, occupants of heavy transport vehicle incurred the highest costs, $44.18 higher than pedestrians; injuries at lower extremities generated higher costs than those at any other site; and vascular injuries caused the greatest costs, $786.24 higher than superficial injuries.

CONCLUSIONS

Road traffic injuries cause huge healthcare costs for victims, most of whom are vulnerable road users. The total cost of hospitalization is incurred mainly for medicine, consumables, diagnosis, medical services, and treatment. Patients' demographic factors (gender and age), clinical factors (injury severity, location, nature, and number of comorbidities), treatment factors (surgery, length of stay, and hospital level), and road user type are all significantly associated with hospitalization costs.

Associated factors from loss productivity among people involved in road traffic accident: a prospective study

OBJECTIVE

To study associated factors with loss productivity in people involved road traffic accidents (RTA).

METHODS

The population based cohort study was conducted in Jequié, Brazil between 2013 to 2015. The instrument for interview was used in people involved in RTA and interview in four months. Individuals, occupational, health conditions, injury and support variables were used for bivariate and multivariate analysis.

RESULTS

The cumulative incidence was loss productivity was 61.1% and density incidence of 7.45 cases/100 person-month. Multivariate analysis showed association for injury (IDR = 4.23; 95%CI = 2.90 - 6.17) and vehicle used with work instrument (IDR = 2.80; 95%CI = 1.62 - 4.85).

CONCLUSION

Public policies are needed to ensure traffic safety in order to minimize the effects of RTA about productivity and to carry news studies to expand knowledge about loss productivity.

Productivity costs among people involved in traffic accidents

This paper aimed to characterize the productivity costs of people involved in traffic accidents (TA) in a medium-sized municipality. A longitudinal household-based study was conducted from 2013 to 2015. During this period, individuals with TA were interviewed, and followed-up and costs of productivity were calculated. The measured and estimated values were considered for the calculation of the gross and per capita values and facilitated the establishment of costs of lost productivity (days off work) and costs of return to productivity (health professionals, medication, transportation, auxiliary devices and vehicle repair). It was shown that the costs of loss were more significant against the costs of return. Among the items that underpin the return to productivity, higher costs were observed in men, young adults, drivers, users of two-wheeled vehicles, people with public employment relationships, intermediate age groups and fracture-type injuries. It is necessary to evaluate and target the stages of recovery of those involved to minimize the social burden generated by these events.

Analysis of the burden and trend of injury in Sichuan, China, from 2006 to 2015: results from the national injury surveillance system

OBJECTIVE

This study investigates the distribution, burden and trends of injuries in Sichuan, China.

DESIGN

A surveillance study using injury data collected by the National Injury Surveillance System.

SETTING AND PARTICIPANTS

312 511 injury cases reported in the National Injury Surveillance System in Sichuan, China, from 2006 to 2015.

PRIMARY OUTCOME MEASURES

Years of potential life lost (YPLL) were calculated to determine the disease burden from injuries. Trend analysis was performed to assess the trends in specific injuries over time.

RESULTS

A total of 312 511 injury cases were reported in the last 10 years in Sichuan with 192 904 (men: 58.58%) and 119 607 (men: 67.11%) cases from the urban and rural surveillance hospitals, respectively. The annual number of injury cases increased from 21 257 in 2006 to 44 112 in 2015 with an average annual increase of 8.45%. The top three common causes of injury were fall (29.3%), animal-related injury (19.1%) and road-related injury (14.6%) in the urban area and fall (38.4%), road-related injury (17.2%) and blunt injuries (16.0%) in the rural area. YPLLs from injuries accounted for 13% of the total YPLLs in the urban area.

CONCLUSIONS

The number of injury cases varied according to rural/urban areas and gender and increased sharply in Sichuan over the last decade. It is necessary to develop targeted prevention and control measures to reduce the disease burden of injuries.

Costs of unintentional injuries among children in an urban slum community in Kampala city, Uganda

Unintentional injuries cause deaths, disabilities, productivity and financial losses and disproportionately affect children in low-income settings yet their cost remains under studied. This study determined the household out-of-pocket expenditure and missed school attendance due to unintentional childhood injuries in a Ugandan slum. We used a cross-sectional household survey design. Data were collected on occurrence and associated costs of unintentional injuries during a one-year period from July 2014 to June 2015. A total of 706 (44.7%) children who had suffered from injuries were reported in the one year period. More male children (N = 415, 58.7%) suffered injuries than females (N = 291, 41.2%). The average out-of-pocket expenditure on treating an injury was US $24.1 [standard deviation (SD) = ±$62.8] and mean school days lost were 25 days (SD = ±51.8). Road traffic injuries (RTIs) resulted in higher costs [mean difference was US $51.1 (95% CI: $11.4-$90.8)] compared to injuries that, for example, occurred at school. In a Ugandan slum community, unintentional childhood injuries resulted in high out-of-pocket expenditures and missed school attendance. The costs varied widely depending on external causes of the injury. These findings highlight the need to invest in population level injury prevention interventions to reduce injury costs by households.

Assessment of clinical parameters of the polytraumatized patient as predictors of hospital expenditure and of its distribution

INTRODUCTION

Traumatic pathology continues to represent an important socio-health problem. The aim of the study was to assess the clinical predictors of total expenditure, as well as to analyze which components of the cost are modified with each clinical parameter of the polytraumatized patient.

MATERIAL AND METHODS

Retrospective study of 131 polytrauma patients registered prospectively. A statistical analysis was carried out to assess the relationship between clinical parameters, the total cost and the cost of various treatment components.

RESULTS

The total cost of hospital admission was 3,791,879 euros. The average cost per patient was € 28,945. Age and gender were not predictors of cost. The scales ISS, NISS and PS were predictors of the total cost and of multiple treatment components. The AIS of Skull and Thorax predicted a higher cost of admission to ICU and Total Cost. The AIS of lower limbs was associated with greater spending on facets of treatment related to surgical activity.

DISCUSSION

There are clinical parameters that are predictors of the treatment cost of the polytraumatized patient. The study describes how the type of trauma that the patient suffers modifies the type of expenses that will present in their hospital admission.

CONCLUSIONS

Polytraumatized patients with severe multisystem injury present increased costs in multiple components of the treatment cost. Patients with TBI or chest trauma present a higher cost for admission to ICU and those with orthopaedic trauma are associated with greater expenditure on surgical activity.

Occupational group, educational level, marital status and deleterious habits among individuals with maxillofacial fractures: retrospective study

Background

To investigate the occupational profile, educational level, marital status and deleterious habits to the health of patients with maxillofacial fractures of a population of northeastern Brazil.

Material and Methods

A retrospective study of patients records admitted to the Division of Oral and Maxillofacial Surgery at the Walter Cantídio University Hospital (Fortaleza, Brazil) who sustained maxillofacial fractures was conducted in the period between 2006 and 2015.

Results

A total of 338 patients rendered 355 fractures. Males were the most affected (p<0.001), with prevalence in the third decade of life (p<0.001). There was a predominance of motorcycle accidents (p<0.001), home workers (p<0.001), low educational status (p = 0.032), and no cigarette use (p<0.001) or alcohol (p = 0.023). Fractures of the zygomatic-orbital complex were the most prevalent in the sample (p<0.001).

Conclusions

The sociodemographic profile exerted a significant influence on the epidemiological profile of maxillofacial fractures in a Brazilian population during the study period.

Key words:Epidemiological studies, trauma, facial bones.