Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
BMC Public Health. 2013 Jun 1;13:531. doi: 10.1186/1471-2458-13-531.
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.
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.
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.
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.
上肢损伤在急诊科就诊中占很大比例。本研究旨在评估 1986 年至 2008 年荷兰人群上肢损伤的发生率，并详细概述相关的医疗保健费用。
计算了 1986 年至 2008 年每年上肢损伤的年龄标准化发生率。计算了每年每个 5 岁年龄组的平均人数，并将其用作标准（参考）人群。从国家伤害监测系统（非住院患者）和国家医疗登记（住院患者）中提取损伤病例。应用基于发病率的成本模型，以估计 2007 年相关的直接医疗保健费用。
上肢损伤的总体年龄调整发生率从 970 人/100,000 人增加到 1,098 人/100,000 人（13%）。发生率最高的是年轻人和老年女性。所有损伤的年总成本为 2.9 亿欧元，其中 1.9 亿欧元用于女性受伤。腕部骨折是最昂贵的损伤（8300 万欧元），因为其发病率高，而上臂骨折是每例最昂贵的损伤（4440 欧元）。由于高发病率和每位患者的成本，老年女性的骨折出现了主要的成本高峰。
1986 年至 2008 年间，荷兰上肢损伤的总体发生率增加了 13%。上肢骨折的女性，尤其是腕部骨折的老年女性，占总费用的很大一部分。
