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 A Look at the Cost of Child and Adolescent Injuries

Spicer_photo.jpgBy Rebecca Spicer, PhD, MPH
Children's Safety Network, Economics and Data Analysis Resource Center

In 2010, 13,819 children and adolescents aged zero to 19 died of an injury. An estimated 310,500 were hospitalized and more than nine million were treated and released from the emergency department. Another 12 million plus injuries were treated in physician offices. However, these numbers tell only part of the story. While incidence data are useful for assessing the magnitude of the problem, costs better account for multiple injury consequences – death, severity, disability, body region, nature of injury – in a single unit of measurement.

The CDC Web-based Injury Statistics Query and Reporting System (WISQARS) Cost of Injuries Module puts cost of injuries right at our fingertips. This brief report 1) examines the burden of injury using 2010 injury costs by cause to children ages zero to 19 and 2) compares total costs and cost per injury by cause. We include all fatal, hospitalized and emergency department visits treated and released. Costs include both medical and work loss costs. Medical costs include medical care, rehabilitation, follow-up care, long-term medical and institutional care, prescriptions, coroner services in the case of fatalities, and the costs of health insurance claims processing. Work loss costs include short-term work loss and the value of wage and household work that a child will be Chart.jpgunable to do if he or she is killed or permanently disabled. It also includes wages and household work that parents are unable to do when caring for their child.

Fatal and medically treated injuries resulted in nearly $30 billion in medical costs and $77 billion in work loss costs (Figure 1). This excludes the costs of the 12 million plus injuries treated in physician offices. Medically treated injuries contribute a large portion of total medical costs while medical costs are small among fatalities. However, work loss costs that the fatally injured child will not contribute make up a substantial portion of total work loss costs.

Unintentional falls, struck by/against, and motor vehicle occupant injuries are the leading contributors to total costs (medical plus work loss) (Table 1).The causes of the most severe injuries are quite different. Unintentional drowning, self-harm/suicide, and unintentional firearm injuries are the leading causes of severe injury according to cost per injury (Table 2). These leading causes include a large proportion of fatalities that result in high work loss costs.

Thus, cost analyses add another dimension in setting priorities and are useful for comparing injury causes, assessing related health burden, and planning cost-effective prevention strategies. In fact, the cost of childhood injuries provides a compelling case for the consistent implementation of evidence-based child safety measures and reinforces the importance of the Affordable Care Act emphasis on prevention and wellness. While we present national estimates of injury costs, the CDC WISQARS Cost of Injury Module also allows state and local health departments to generate reports using their own counts of fatalities, hospitalizations and/or emergency department visits.

Data Source: NCHS Vital Statistics System for numbers of deaths. NEISS All Injury Program operated by the U.S. Consumer Product Safety Commission (CPSC) for numbers of nonfatal injuries. Pacific Institute for Research and Evaluation (PIRE), Calverton, MD for unit cost estimates. Accessed online: https://wisqars.cdc.gov:8443/ costT/cost_Part1_Intro.jsp.

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