BMC Public Health | |
Trends in incidence and costs of injuries to the shoulder, arm and wrist in The Netherlands between 1986 and 2008 | |
Esther MM Van Lieshout1  Dennis Den Hartog1  Peter Patka3  Denise Eygendaal2  Martien JM Panneman4  Gijs IT Iordens1  Suzanne Polinder5  | |
[1] Department of Surgery-Traumatology, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands;Department of Orthopaedic Surgery, Upper Limb Unit, Amphia Hospital, P.O. Box 90158, 4800 RK Breda, The Netherlands;Department of Emergency Medicine, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands;Consumer & Safety Institute, P.O. Box 75169, 1070 AD Amsterdam, The Netherlands;Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands | |
关键词: Upper extremity; Registry; Incidence; Health care cost; Fracture; Elderly; | |
Others : 1162150 DOI : 10.1186/1471-2458-13-531 |
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received in 2012-07-02, accepted in 2013-03-20, 发布年份 2013 | |
【 摘 要 】
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.
【 授权许可】
2013 Polinder et al.; licensee BioMed Central Ltd.
【 预 览 】
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【 参考文献 】
- [1]Zacchilli MA, Owens BD: Epidemiology of shoulder dislocations presenting to emergency departments in the United States. J Bone Joint Surg Am 2010, 92(3):542-549.
- [2]Melton LJ 3rd, Gabriel SE, Crowson CS, Tosteson AN, Johnell O, Kanis JA: Cost-equivalence of different osteoporotic fractures. Osteoporos Int 2003, 14(5):383-388.
- [3]Rennie L, Court-Brown CM, Mok JY, Beattie TF: The epidemiology of fractures in children. Injury 2007, 38(8):913-922.
- [4]Palvanen M, Kannus P, Niemi S, Parkkari J: Update in the epidemiology of proximal humeral fractures. Clin Orthop Relat Res 2006, 442:87-92.
- [5]Kannus P, Palvanen M, Niemi S, Sievanen H, Parkkari J: Rate of proximal humeral fractures in older Finnish women between 1970 and 2007. Bone 2009, 44(4):656-659.
- [6]Palvanen M, Kannus P, Niemi S, Parkkari J: Secular trends in the osteoporotic fractures of the distal humerus in elderly women. Eur J Epidemiol 1998, 14(2):159-164.
- [7]Orces CH, Martinez FJ: Epidemiology of fall related forearm and wrist fractures among adults treated in US hospital emergency departments. Inj Prev 2011, 17(1):33-36.
- [8]Larsen CF, Lauritsen J: Epidemiology of acute wrist trauma. Int J Epidemiol 1993, 22(5):911-916.
- [9]Kannus P, Palvanen M, Niemi S, Parkkari J, Jarvinen M, Vuori I: Osteoporotic fractures of the proximal humerus in elderly Finnish persons: sharp increase in 1970–1998 and alarming projections for the new millennium. Acta Orthop Scand 2000, 71(5):465-470.
- [10]Kannus P, Palvanen M, Niemi S, Parkkari J, Jarvinen M, Vuori I: Increasing number and incidence of osteoporotic fractures of the proximal humerus in elderly people. BMJ 1996, 313(7064):1051-1052.
- [11]Josefsson PO, Nilsson BE: Incidence of elbow dislocation. Acta Orthop Scand 1986, 57(6):537-538.
- [12]Ekholm R, Adami J, Tidermark J, Hansson K, Tornkvist H, Ponzer S: Fractures of the shaft of the humerus. An epidemiological study of 401 fractures. J Bone Joint Surg Br 2006, 88(11):1469-1473.
- [13]Court-Brown CM, Garg A, McQueen MM: The epidemiology of proximal humeral fractures. Acta Orthop Scand 2001, 72(4):365-371.
- [14]Bell JE, Leung BC, Spratt KF, Koval KJ, Weinstein JD, Goodman DC, Tosteson AN: Trends and variation in incidence, surgical treatment, and repeat surgery of proximal humeral fractures in the elderly. J Bone Joint Surg Am 2011, 93(2):121-31.
- [15]Robinson CM, Hill RM, Jacobs N, Dall G, Court-Brown CM: Adult distal humeral metaphyseal fractures: epidemiology and results of treatment. J Orthop Trauma 2003, 17(1):38-47.
- [16]Lofthus CM, Frihagen F, Meyer HE, Nordsletten L, Melhuus K, Falch JA: Epidemiology of distal forearm fractures in Oslo, Norway. Osteoporos Int 2008, 19(6):781-786.
- [17]Kaas L, Van Riet RP, Vroemen JP, Eygendaal D: The epidemiology of radial head fractures. J Shoulder Elbow Surg 2010, 19(4):520-523.
- [18]Van Staa TP, Dennison EM, Leufkens HG, Cooper C: Epidemiology of fractures in England and Wales. Bone 2001, 29(6):517-522.
- [19]Meerding WJ, Mulder S, Van Beeck EF: Incidence and costs of injuries in The Netherlands. Eur J Public Health 2006, 16(3):272-278.
- [20]Kilgore ML, Morrisey MA, Becker DJ, Gary LC, Curtis JR, Saag KG, Yun H, Matthews R, Smith W, Taylor A, Arora T, Delzell E: Health care expenditures associated with skeletal fractures among Medicare beneficiaries, 1999–2005. J Bone Miner Res 2009, 24(12):2050-2055.
- [21]Ohsfeldt RL, Borisov NN, Sheer RL: Fragility fracture-related direct medical costs in the first year following a nonvertebral fracture in a managed care setting. Osteoporos Int 2006, 17(2):252-258.
- [22]Roudsari BS, Ebel BE, Corso PS, Molinari NA, Koepsell TD: The acute medical care costs of fall-related injuries among the U.S. older adults. Injury 2005, 36(11):1316-1322.
- [23]Leslie WD, Metge CJ, Azimee M, Lix LM, Finlayson GS, Morin SN, Caetano P: Direct costs of fractures in Canada and trends 1996–2006: a population-based cost-of-illness analysis. J Bone Miner Res 2011, 26(10):2419-2429.
- [24]Meerding WJ, Polinder S, Lyons RA, Petridou ET, Toet H, Van Beeck F, Mulder S: How adequate are emergency department home and leisure injury surveillance systems for cross-country comparisons in Europe? Int J Inj Contr Saf Promot 2010, 17(1):13-22.
- [25]Van der Stegen R, Ploemacher J: [Discription of methods for statistics by diagnoses in time by using the LMR (1981–2005)]. The Hague: Statistics Netherlands (CBS); 2009:9.
- [26]Statistics Netherlands (CBS)http://www.cbs.nl webcite; last accessed on April 5, 2012
- [27]Curtin LR, Klein RJ: Direct standardization (age-adjusted death rates). Healthy People 2000 Stat Notes 1995, 6:1-10.
- [28]Hartholt KA, Van Lieshout EMM, Polinder S, Panneman MJM, Van der Cammen TJM, Patka P: Rapid increase in hospitalizations resulting from fall-related traumatic head injury in older adults in The Netherlands 1986–2008. J Neurotrauma 2011, 28(5):739-744.
- [29]Hartholt KA, Van Beeck EF, Polinder S, Van der Velde N, Van Lieshout EMM, Panneman MJM, Van der Cammen TJM, Patka P: Societal Consequences of Falls in the Older Population: Injuries, Healthcare Costs, and Long-Term Reduced Quality of Life. J Trauma 2011, 71(3):748-753.
- [30]Hartholt KA, Van der Velde N, Looman CWN, Van Lieshout EMM, Panneman MJM, Van Beeck EF, Patka P, Van der Cammen TJM: Trends in fall-related hospital admissions in older persons in the Netherlands. Arch Intern Med 2010, 170(10):905-911.
- [31]Consumer and Safety Institute: The Dutch Burden of Injury Model. Amsterdam: Consumer and Safety Institute; 2005.
- [32]Polinder S, Van Beeck EF, Essink-Bot ML, Toet H, Looman CW, Mulder S, Meerding WJ: Functional outcome at 2.5, 5, 9, and 24 months after injury in the Netherlands. J Trauma 2007, 62(1):133-141.
- [33]Oostenbrink JB, Koopmanschap MA, Rutten FF: Standardisation of costs: the Dutch Manual for Costing in economic evaluations. Pharmacoeconomics 2002, 20(7):443-454.
- [34]Ryan LM, Teach SJ, Searcy K, Singer SA, Wood R, Wright JL, Chamberlain JM: Epidemiology of pediatric forearm fractures in Washington, DC. J Trauma 2010, 69(4 Suppl):S200-S205.
- [35]Borse N, Sleet DA, CDC Childhood Injury Report: Patterns of Unintentional Injuries Among 0- to 19-Year Olds in the United States, 2000–2006. Fam Community Health 2009, 32(2):189.
- [36]Cummings SR, Melton LJ: Epidemiology and outcomes of osteoporotic fractures. Lancet 2002, 359(9319):1761-1767.
- [37]Kroner K, Lind T, Jensen J: The epidemiology of shoulder dislocations. Arch Orthop Trauma Surg 1989, 108(5):288-290.
- [38]Simonet WT, Melton LJ 3rd, Cofield RH, Ilstrup DM: Incidence of anterior shoulder dislocation in Olmsted County, Minnesota. Clin Orthop Relat Res 1984, 186:186-191.
- [39]Tarantino U, Cannata G, Cerocchi I, Lecce D, Iundusi R, Celi M: Surgical approach to fragility fractures: problems and perspectives. Aging Clin Exp Res 2007, 19(4 Suppl):12-21.
- [40]Fjalestad T, Hole MO, Jorgensen JJ, Stromsoe K, Kristiansen IS: Health and cost consequences of surgical versus conservative treatment for a comminuted proximal humeral fracture in elderly patients. Injury 2010, 41(6):599-605.
- [41]von Keyserlingk C, Boutis K, Willan AR, Hopkins RB, Goeree R: Cost-effectiveness analysis of cast versus splint in children with acceptably angulated wrist fractures. Int J Technol Assess Health Care 2011, 27(2):101-107.
- [42]Lyons RA, Polinder S, Larsen CF, Mulder S, Meerding WJ, Toet H, Van Beeck E, Eurocost Reference Group: Methodological issues in comparing injury incidence across countries. Int J Inj Contr Saf Promot 2006, 13(2):63-70.