Incidence and costs of injuries in

Background: Injuries are amajor and persistent public health problem, but a comprehensive and detailed overview of the economic burden is missing. We therefore estimated the number of emergency depart-ment (ED) attendances and health care costs as a result of injury.Methods:We estimated lifetime health care costs of injuries occurring in The Netherlands in the year 1999. Patient groups were defined that are homogeneous in terms of health service use. Health service use and costs per patient groupwas estimated with data from national databases and a prospective study among 5755 injury patients. Results: Total health care costs due to injury in 1999 were d1.15 billion, or 3.7 % of the total health care budget. Major cost peaks were observed among males between ages 15 and 44 due to a high incidence, and among females from age 65 onwards due to a high incidence and high costs per patient. For the age groups 0–14, 15–44, 45–64, and 65þ ED attendances per 1000 person years were 85, 85, 43, and 49, respectively, and costs per capita wered38,d59,d43, andd210, respectively. Costs per patient rise about linearly up to age 60 and about exponentially thereafter. From age 25 onwards, females have higher costs per patient than males. Hip fracture (20%), superficial injury (13%), open wounds (7%), and skull–brain injury (6%) had the highest total costs. Most costs were attributable to falls (44%) and traffic injuries (19%). Conclusion: Young adult males, elderly females, falls, hip fractures, and minor injuries without medical need fo