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Costs and outcome for serious hand and arm injuries during the first year after trauma - a prospective study

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Author

Summary, in English

Background: To study costs and outcome for serious hand and arm injuries during the first year after the trauma. Methods: In patients with a Hand Injury Severity Score (HISS) > 50, DASH and EQ-5D scores as well as factors related to costs within the health care sector, costs due to lost production and total costs were evaluated. Coxregression analysis stratifying for mechanism of injury was used to analyse return to work. Results: The majority of the 45 included patients (median 42 years 16-64) were men with severe (n = 9) or major (n = 36) injuries with different type of injuries (amputations n = 13; complex injuries n = 18; major nerve injuries/full house n = 13; burn injury n = 1). DASH and EQ-5D decreased and increased, respectively, significantly over time during one year. Total costs (+ 34%) and costs of lost production were highest for persons injured at work. Factors associated with higher health care costs were age > 50 years (+ 52%), injury at work (+ 40%) and partial labour market activity (+ 66%). Costs of lost production had a significant role in total costs of injury. Patients with major injuries had longer duration of sick leave. Patients with severe injuries were more likely to return to work [(RR 3.76 (95% CI 1.38-10.22) from Cox regression, controlling for age, gender and presence of nerve injury]. Conclusions: Despite the fact that work environments have constantly improved over the last decades, we found that hand injuries at work were most costly both in terms of health care and costs of lost production, although the severity, i.e. HISS, did not differ from injuries occurring at home or during leisure.

Publishing year

2013

Language

English

Publication/Series

BMC Public Health

Volume

13

Document type

Journal article

Publisher

BioMed Central (BMC)

Topic

  • Public Health, Global Health, Social Medicine and Epidemiology

Keywords

  • Hand injury
  • HISS
  • DASH
  • EQ-5D
  • Costs
  • Health care costs
  • Complex
  • injury
  • Nerve injury

Status

Published

Research group

  • Hand Surgery, Malmö
  • Health Economics
  • Sustainable occupations and health in a life course perspective

ISBN/ISSN/Other

  • ISSN: 1471-2458