WISQARS Cost of Injury for public health research and practice

Abstract

Aim: Since 2011 the Centers for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System (WISQARS) has demonstrated per-injury average and population total medical and non-medical costs of injuries by type (such as unintentional cut/pierce) in the USA. This article describes the impact of data and methods changes in the newest version of WISQARS Cost of Injury.

Methods: Data sources and methods were compared for the legacy version of the WISQARS Cost of Injury website (available 2011-2021; most recent prior update was published in 2014 with 2010 injury incidence and costs) and the new version (published 2021; 2015-present injury incidence and costs). Cost data sources were updated for the new website and the basis for medical costs and non-fatal injury work loss costs changed from mathematical modelling (combined estimates from multiple data sources) in the legacy website to statistical modelling of actual injury-related medical and work loss financial transactions in the new website. Monetary valuation of non-medical costs for injury deaths changed from lost employment income and household work in the legacy website to value of statistical life. Quality of life loss costs were added for non-fatal injuries. Per-injury average medical and non-medical costs by injury type (mechanism and intent) and total population injury costs were compared for years 2010 (legacy website data) and 2020 (new website data) to illustrate the impact of data and methods changes on reported costs in the context of changed annual injury incidence.

Results: Owing to more comprehensive cost capture yielding higher per-injury average costs for most injury types-including those with high incidence in 2020 such as unintentional poisoning and unintentional falls-reported total US medical and non-medical injury costs were substantially higher in 2020 (US$4.6 trillion) compared with 2010 (US$693 billion) (both 2020 USD).

Conclusions and relevance: New data and methods increased the injury costs reported in WISQARS Cost of Injury. Researchers and public health professionals can use this information to proficiently communicate the burden of injuries and violence in terms of economic cost.

Keywords: costs; economic analysis; mechanism.

Figure 1

Number and average cost of injuries and change from 2010: Deaths, USA, 2020. Notes. Data source: WISQARS cost of injury. Ranked by 2020 incidence. Costs are 2020 USD. Injury types with ≥20 deaths in both 2010 and 2020 are reported. The legacy WISQARS cost of injury website reporting 2010 injury costs was archived when the new website was published in December 2021. WISQARS, Web-based Injury Statistics Query and Reporting System; VSL, Value of statistical life.

Figure 2

Number and average cost of injuries and change from 2010: Non-fatal ED T&R visits, USA, 2020. notes. Data source: WISQARS cost of injury. Ranked by 2020 incidence. Costs are 2020 USD. Injury types with ≥20 unweighted count, ≥1200 weighted count or coefficient of variation of the estimate ≤30% for both 2010 and 2020 are reported. The legacy WISQARS cost of injury website reporting 2010 injury costs was archived when the new website was published in December 2021. ED, emergency department; QoL, quality of life; T&R, treated and released; WISQARS, Web-based Injury Statistics Query and Reporting System.

Figure 3

Number and average cost of injuries and change from 2010: Non-fatal hospitalisations, USA, 2020. Notes. Data source: WISQARS cost of injury. Ranked by 2020 incidence. Costs are 2020 USD. Injury types with ≥20 unweighted count, ≥1200 weighted count or coefficient of variation of the estimate ≤30% for both 2010 and 2020 are reported. The legacy WISQARS cost of injury website reporting 2010 injury costs was archived when the new website was published in December 2021. QoL, quality of life; WISQARS, Web-based Injury Statistics Query and Reporting System.