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. 2013 May 24:13:501.
doi: 10.1186/1471-2458-13-501.

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

Hans-Eric Rosberg  1 , Katarina Steen Carlsson, Ragnhild I Cederlund, Eva Ramel, Lars B Dahlin
Affiliations

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

Hans-Eric Rosberg et al. BMC Public Health. .

Abstract

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. Cox-regression 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.

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Figures

Figure 1
Figure 1
Hand Injury Severity Score (a), DASH scores (b), EQ-5D (c) and costs related to change in DASH score (d) in the 45 patients with a severe and major hand injury.
Figure 2
Figure 2
The total costs consist of health care costs (blue) and costs of lost production (red) and divided by place of injury (a) by labour market activity category (b) and by type of injury (c) for the 45 patients with a severe and major hand injury.
Figure 3
Figure 3
Proportion of patients with a major or severe hand injury remaining on sick-leave at different points in time.
See this image and copyright information in PMC

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