Economic Cost of Childhood Unintentional Injuries

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Abstract

Aims:

This study aims to review the economic cost of childhood (0-18 years) unintentional injuries (UI) and focuses upon comparing the cost burden between developing and developed countries.

Methods:

Articles were selected from PUBMED using the search words “ Economic Cost”, “ Unintentional injuries” and “ Children”. Nine articles were selected.

Results:

Studies in China focused upon cost to hospitals, in Bangladesh they focused on personal payment in rural areas, and in Vietnam they focused upon community-based cost analysis. There was one study from Norway on UI at home. There were 5 articles from the USA focusing on submersion injury, UI insurance, unintentional traumatic brain injury, UI due to firearms and UI medical costs. The cost of childhood UI is enormous, ranging from US $516,938 to US $9,550,704 per year. This represents a large economic burden on society. Additionally, there is a large gap between lower-middle income countries (LMIC) and high income countries (HIC) in the burden of injury, injury health care and insurance systems.

Conclusion:

Different bases and contexts of studies make it difficult to draw a solid conclusion about the amount of costs of UI among children. Therefore, more studies of children's unintentional injuries should be carried out in low and middle income countries.

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Most cited references 35

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Sicker and poorer--the consequences of being uninsured: a review of the research on the relationship between health insurance, medical care use, health, work, and income.

Jack Hadley (2003)

Health services research conducted over the past 25 years makes a compelling case that having health insurance or using more medical care would improve the health of the uninsured. The literature's broad range of conditions, populations, and methods makes it difficult to derive a precise quantitative estimate of the effect of having health insurance on the uninsured's health. Some mortality studies imply that a 4% to 5% reduction in the uninsured's mortality is a lower bound; other studies suggest that the reductions could be as high as 20% to 25%. Although all of the studies reviewed suffer from methodological flaws of varying degrees, there is substantial qualitative consistency across studies of different medical conditions conducted at different times and using different data sets and statistical methods. Corroborating process studies find that the uninsured receive fewer preventive and diagnostic services, tend to be more severely ill when diagnosed, and receive less therapeutic care. Other literature suggests that improving health status from fair or poor to very good or excellent would increase both work effort and annual earnings by approximately 15% to 20%.

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Age and gender differences in risk-taking behaviour as an explanation for high incidence of motor vehicle crashes as a driver in young males.

Rod McClure, Hugo C. Turner (2003)

Risk-taking behaviour has been identified as a possible explanation for the high incidence of motor vehicle crashes involving young male drivers. This study examines the extent to which differences in risk-taking behaviour explain the differential crash rates by age and gender. A random sample of 689 adults aged 17-88 were selected from motor vehicle license holders within randomly selected geographical areas across Queensland. Participants completed a questionnaire covering their attitudes towards driving behaviour and general risk-taking behaviour, selected demographic characteristics and self-reported history of road crashes as a driver. Univariate analysis showed that males scored higher means than females in driver aggression and thrill seeking and in their general risk acceptance. Multivariate logistic regression analysis indicated that males were twice as likely (OR 2.46, CI 1.59-3.83) to have reported at least one crash as a driver compared to females and nearly three times as likely (OR 2.88, CI 1.84-4.49) to have reported two or more crashes. Drivers aged 17-29 were also twice as likely (OR 2.31, CI 1.10-4.19) to have reported at least one crash when compared to those aged over 50 years. When risk-taking behaviours were introduced into the logistic model the odds of males (OR 1.70, CI 1.29-3.30) or 17-29 year olds (OR 1.30, CI 0.93-3.91) being involved in at least one crash substantially reduced. An increased risk of a crash as a driver can, in part, be explained by the age and gender differential in risk-taking behaviour. The challenge for public health professionals is to determine suitable strategies to modify risk-taking behaviour in young or male drivers.

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Insurance coverage, medical care use, and short-term health changes following an unintentional injury or the onset of a chronic condition.

Jack Hadley (2007)

Given the large and increasing number of uninsured US individuals, identifying the health consequences of being uninsured has assumed increased importance. To compare medical care use and short-term health changes among US uninsured individuals and insured nonelderly individuals following a health shock caused by either an unintentional injury or the onset of a chronic condition. Multivariate logistic regression analysis of longitudinal data from Medical Expenditure Panel Surveys (1997-2004) limited to nonelderly individuals whose insurance status was established for 2 months prior to 1 or more unintentional injuries (20 783 cases among 15 866 individuals) and onset of 1 or more chronic conditions (10 485 cases among 7954 individuals). Self-reported medical care use and change in short-term general health status following the health shock. After experiencing a health shock, uninsured individuals were less likely to obtain any medical care (unintentional injury [UI] group: 78.8% uninsured vs 88.7% insured [adjusted odds ratio {AOR}, 0.47; 95% confidence interval {CI}, 0.43-0.51]; new chronic condition [NCC] group: 81.7% uninsured vs 91.5% insured [AOR, 0.45; 95% CI, 0.40-0.50]) and more likely not to have received any recommended follow-up care (UI group: 19.3% uninsured vs 9.2% insured [AOR, 2.59; 95% CI, 2.15-3.11]; NCC group: 9.4% uninsured vs 4.4% insured [AOR, 1.65; 95% CI, 1.32-2.06]). Based on the AORs, uninsured individuals with UIs had fewer outpatient visits (6.1% uninsured vs 9.0% insured; AOR, 0.71 [95% CI, 0.63-0.80]), office-based visits (41.8% uninsured vs 57.3% insured; AOR, 0.59 [95% CI, 0.56-0.62]), and prescription medicines (35.5% uninsured vs 35.6% insured; AOR, 0.71 [95% CI, 0.67-0.75]). Uninsured individuals with an NCC had fewer office-based visits (58.9% uninsured vs 68.3% insured; AOR, 0.77 [95% CI, 0.72-0.82]) and prescription medicines (52.7% uninsured vs 61.7% insured; AOR, 0.66 [95% CI, 0.57-0.76]). Higher proportions of uninsured individuals reported a decrease in health status (classified as much worse) approximately 3.5 months after the health shock (UI group: 9.8% uninsured vs 6.7% insured; AOR, 0.86 [95% CI, 0.75-0.98]; NCC group: 12.3% uninsured vs 10.1% insured; AOR, 0.74 [95% CI, 0.68-0.80]). Uninsured individuals with UIs were more likely to report not being fully recovered and no longer receiving treatment. At approximately 7 months after the health shock, uninsured individuals with NCCs still reported worse health status. Among individuals who experienced a health shock caused by an unintentional injury or a new chronic condition, uninsured individuals reported receiving less medical care and poorer short-term changes in health than those with insurance.

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Author and article information

Journal

Journal ID (nlm-ta): Int J Prev Med

Journal ID (iso-abbrev): Int J Prev Med

Journal ID (publisher-id): IJPVM

Title: International Journal of Preventive Medicine

Publisher: Medknow Publications & Media Pvt Ltd (India )

ISSN (Print): 2008-7802

ISSN (Electronic): 2008-8213

Publication date (Print): May 2012

Volume: 3

Issue: 5

Pages: 303-312

Affiliations

[1]Independent Researcher, China

[1 ]Department of Public Health Science, School of Life Sciences, University of Skövde, Skövde, Sweden

[2 ]School of Health & Medical Sciences, Örebro University, Örebro, Sweden

Author notes

Correspondence to: Prof. Koustuv Dalal, Department of Public Health Science, School of Health & Medical Sciences, Örebro University, Prisma House, SE-701 82 Örebro, Sweden. E-mail: koustuv2010@ 123456hotmail.com

Article

Publisher ID: IJPVM-3-303

PMC ID: 3372072

PubMed ID: 22708026

SO-VID: 660a6c78-fbbb-43c4-ad19-11dcf4aed4db

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Economic Cost of Childhood Unintentional Injuries

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The International Journal of Person Centered Medicine

Most cited references 35

Sicker and poorer--the consequences of being uninsured: a review of the research on the relationship between health insurance, medical care use, health, work, and income.

Age and gender differences in risk-taking behaviour as an explanation for high incidence of motor vehicle crashes as a driver in young males.

Insurance coverage, medical care use, and short-term health changes following an unintentional injury or the onset of a chronic condition.

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