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

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Costs and outcome for serious hand and arm injuries during the first year after trauma - a prospective study. / Rosberg, HansE; Steen Carlsson, Katarina; Cederlund, Ragnhild; Ramel, Eva; Dahlin, Lars.

I: BMC Public Health, Vol. 13, 501, 2013.

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

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T1 - Costs and outcome for serious hand and arm injuries during the first year after trauma - a prospective study

AU - Rosberg, HansE

AU - Steen Carlsson, Katarina

AU - Cederlund, Ragnhild

AU - Ramel, Eva

AU - Dahlin, Lars

PY - 2013

Y1 - 2013

N2 - 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. Coxregression 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.

AB - 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. Coxregression 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.

KW - Hand injury

KW - HISS

KW - DASH

KW - EQ-5D

KW - Costs

KW - Health care costs

KW - Complex

KW - injury

KW - Nerve injury

U2 - 10.1186/1471-2458-13-501

DO - 10.1186/1471-2458-13-501

M3 - Article

VL - 13

JO - BMC Public Health

T2 - BMC Public Health

JF - BMC Public Health

SN - 1471-2458

M1 - 501

ER -