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. 2013 Jun 1:13:531.
doi: 10.1186/1471-2458-13-531.

Trends in incidence and costs of injuries to the shoulder, arm and wrist in The Netherlands between 1986 and 2008

Suzanne Polinder  1 , Gijs I T Iordens, Martien J M Panneman, Denise Eygendaal, Peter Patka, Dennis Den Hartog, Esther M M Van Lieshout
Affiliations

Trends in incidence and costs of injuries to the shoulder, arm and wrist in The Netherlands between 1986 and 2008

Suzanne Polinder et al. BMC Public Health. .

Abstract

Background: Upper extremity injuries account for a large proportion of attendances to the Emergency Department. The aim of this study was to assess population-based trends in the incidence of upper extremity injuries in the Dutch population between 1986 and 2008, and to give a detailed overview of the associated health care costs.

Methods: Age-standardized incidence rates of upper extremity injuries were calculated for each year between 1986 and 2008. The average number of people in each of the 5-year age classes for each year of the study was calculated and used as the standard (reference) population. Injury cases were extracted from the National Injury Surveillance System (non-hospitalized patients) and the National Medical Registration (hospitalized patients). An incidence-based cost model was applied in order to estimate associated direct health care costs in 2007.

Results: The overall age-adjusted incidence of upper extremity injuries increased from 970 to 1,098 per 100,000 persons (13%). The highest incidence was seen in young persons and elderly women. Total annual costs for all injuries were 290 million euro, of which 190 million euro were paid for injuries sustained by women. Wrist fractures were the most expensive injuries (83 million euro) due to high incidence, whereas upper arm fractures were the most expensive injuries per case (4,440 euro). Major cost peaks were observed for fractures in elderly women due to high incidence and costs per patient.

Conclusions: The overall incidence of upper extremity injury in the Netherlands increased by 13% in the period 1986-2008. Females with upper extremity fractures and especially elderly women with wrist fractures accounted for a substantial share of total costs.

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Figures

Figure 1
Figure 1
Age-adjusted incidence (per 100,000 person-years) of upper extremity injuries in the period 1996–2008. Data are shown for males and females separately.
Figure 2
Figure 2
Age-adjusted incidence (per 100,000 person-years) of upper extremity injuries in the period 1996–2008. Data are shown by age and gender (A) or anatomic location (B).
Figure 3
Figure 3
Age-adjusted incidence (per 100,000 person-years) of the shoulder (A-B), arm (C-D) and wrist (E-F) by age. Data for 2007 are shown. Data are shown for males (A, C, E) and females (B, D, F) separately.
Figure 4
Figure 4
Total costs related to injuries of the shoulder, arm and wrist. Data for 2007 are shown, subdivided into three age groups for males and females.
See this image and copyright information in PMC

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