Reducing the Burden of Injury Advancing Prevention and Treatment (1999) / Chapter Skim
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2 Magnitude and Cost
2 Magnitude and Cost
Pages 41-59
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From page 41... ...
Direct costs were inflated using the appropriate component of the Consumer Price Index (hospital and related services, physicians' services, prescription drugs, professional medical services, and medical care services)
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From page 42... ...
42 REDUCING THE BURDEN OF INJURY Age Groups 5-9 Rank <1 1-4 10-14 1 5-24 1 2 3 4 5 6 7 8 9 10 SIDS 3,397 Respiratory Distress Synd. 1,454 Maternal Complications 1,309 Placenta Cord Membranes 962 Perinatal Infections 788 _ Pneumonia & Influenza 492 Intrauterine Hypoxia 475 Congenital Anomalies 6,554 Short Gestation 3,933 Malignant Neoplasms 488 Congenital Anomalies 695 Malignant Neoplasms 523 Malignant Neoplasms 503 Congenital Anomalies 242 Heart Disease 251 HIV 210 Pneumonia & Influenza 156 i Perinatal Period 87 Septicemia 80 Cerebro vascular 57 Heart Disease 130 HIV 123 Pneumonia & Influenza 73 Benign Neoplasms 50 Bronchitis Emphysema Asthma 38 Anemias 31 Suicide 330 Congenital Anomalies 207 Heart Disease 164 Bronchitis Emphysema Asthma 1 05 HIV 66 Benign Neoplasms 55 Pneumonia & Influenza 55 Suicide 4,784 Malignant Neoplasms 1,642 Heart Disease 1,039 HIV 629 Congenital Anomalies 452 Bronchitis Emphysema Asthma 246 Pneumonia & Influenza 207 Cerebro vascular 172 FIGURE 2.1 Ten leading causes of death by age group, 1995.
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From page 43... ...
MAGNITUDE AND COSTS Age Groups 45-54 Malignant Neoplasms 44,1 86 43 25-34 35-44 - HIV i" 18,860 it_ 55-64 Malignant Neoplasms 87,898 65+ Total Heart Disease 737,563 _ 1 Heart Disease 61 5,426 HIV 1 1,894 Suicide 6,292 Malignant Neoplasms 17,110 Heart Disease 34,498 Heart Disease 68,240 Bronchitis - Emphysema i_ Asthma 9,988 Malignant Neoplasms 381,142 Cerebrovascular 138,762 Malignant Neoplasms 538,455 Cerebrovascular 157,991 : : : : i:::: ~ ::: ~ ~:~ ~ ~ ~:~ ~Hornic~da~ :: Malignant Neoplasms 4,875 Heart Disease 3,461 Cerebro vascular 720 Pneumonia & Influenza 622 Diabetes 614 Liver Disease 604 Heart Disease 13,603 Suicide 6,467 .
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From page 44... ...
Measuring the overall magnitude of injury as a major public health problem is crucial in the development of a rational basis for resource allocation, for defining strategies for prevention interventions, and for determining their outcomes. As surveillance efforts have continued to improve, we have gained increasing knowledge about the magnitude of the injury problem and the costs to society; however, knowledge is sparse regarding nonfatal injuries, the settings in which they occur, and the total costs associated with injury morbidity.
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From page 45... ...
For at least the past 30 years, motor vehicle and firearm injuries have been the two leading causes of injury death (see Chapter 51. In 1995, motor vehicle traff~c-related injuries accounted for 29 percent of all injury deaths, or 42,452 deaths.
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From page 46... ...
The increase in the homicide rate has not been steady; there was a 32 percent increase between 1985 and 1991, followed by a decrease of 15 percent from 1991 to 1995. Age-adjusted motor vehicle traff~c-related death rates declined 15 percent from 1985 to 1993, but increased 2 percent from 1993 to 1995.3 In 1995, 18,428 persons 15 to 34 years of age died of a motor vehicle traffic injury, comprising 43 percent of all motor vehicle traffic injury deaths.
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From page 47... ...
The age-adjusted firearm death rate increased by 22 percent from 12.8 per 100,000 in 1985 to 15.6 per 100,000 in 1993, followed by an 11 percent decline from 1993 to 1995 to 13.9 per 100,000. The increase in firearm death rates can be attributed almost exclusively to an increase in firearm homicides among adolescents and young adults ages 15 to 34.
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From page 48... ...
The motor vehicle traffic injury death rate remained unchanged at 15.8 per 100,000 and the firearm death rate declined 7 percent to 12.9 per 100,000 population. Most of the decline is attributed to the 11 percent decline in the firearm homicide rate (with a more modest decline of 3 percent in the firearm suicide rate)
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From page 49... ...
Although most nonfatal injuries are of minor severity and do not result in more than one or two days of restricted activity, a large number result in fractures, brain injuries, major burns, or other significant disability. In 1992-1994, the average hospital discharge rates for fractures which account for nearly 2 out of 5 injury-related discharges was 39.3 per 10,000 persons.
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From page 50... ...
Homicide rates were higher for the black population than for other groups. Motor vehicle traffic injuries were the leading cause of unintentional injury in each race and ethnic group.
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From page 51... ...
For persons 65 years of age and over, injury discharge rates for white females were 1.4 times the rates for black females. Emergency Department Visits About 4 of 10 ED visits were for injuries.
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From page 52... ...
Among infants, suffocation was the leading cause of injury death. The five leading causes of injury death among infants and children under 15 years of age motor vehicle traffic injuries, fires and burns, drowning, suffocation, and firearms accounted for 80 percent of injury deaths.
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From page 53... ...
Approximately one-third of nonfatal injuries are sustained by workers in eight industries (restaurants and bars, hospitals, nursing and personal care facilities, trucking and non-air courier services, grocery stores, department stores, motor vehicles and equipment, and hotels and motels) , with the highest incidence rate (17.8 per 100 full-time workers)
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From page 54... ...
Using a cost-of-illness or human capital approach to valuing health, estimates of the cost of injury have been derived for several major categories (e.g., motor vehicles, firearms, falls, fires and burns, poisonings) of injury (Rice et al., 1989; Max and Rice, 1993; Miller et al., 1995; NSC, 1997; Blincoe, 1997; Leigh et al.,
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From page 55... ...
These costs can add significantly to the overall cost of injuries from certain mechanisms such as motor vehicle crashes and fires or burns. Costs accrued to family members who lose time from work in order to take care of the injured can also contribute to the total lifetime costs, but these are difficult to determine (Chirikos, 1989~.
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From page 56... ...
However, some critics of the human capital method claim that it overestimates true indirect costs because it does not take into account the possibility of substitution among workers when there is relatively high unemployment. These critics contend that indirect costs should be restricted to temporary production losses and to resources expended to recruit and train new employees.
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From page 57... ...
The weights used to calculate QALYs should be based on the preferences people have for various health states and are expressed on an interval scale, with optimal health having a value of 1 and death having a value of 0. They have been derived using a variety of different health state classification systems, including the EuroQol (EuroQol Group, 1990 )
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From page 58... ...
In projecting the future global burden of disease, it was found that road traffic injuries alone will rise from ninth place overall as a leading cause of disease burden to third place by the year 2020. Violence, which is currently in nineteenth place as a cause of disease burden is expected to rise to twelfth place and suicide from seventeenth place to fourteenth place (Murray and Lopez, 1996~.
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From page 59... ...
1998. Ten Leading Causes of Death by Age Group, 1995.
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