Injury: the medical and related costs in New Zealand 1990.

AIM

To describe the cost of inpatient admissions and emergency department attendances for injury at a major New Zealand hospital; and to extrapolate to indicative national costs for injury, with a view to facilitating decision making, in relation to injury prevention programs.

METHODS

By using data from the patient management system database and the resource utilisation system operating at Dunedin Hospital to describe the utilisation spectrum for injury related events.

RESULTS

The institutional cost of inpatient care for injury cases for the year ending 31 December 1990 amounted to $7,378,000, at an average of $3,020 a case. The costs for emergency department attendances (not resulting in admission) amounted to $2,585,000, at an average of $93 a case; the total of $9,963,000 equated to 15% of the hospitals annual operating budget. The most expensive causes of admission with injury were falls and motor vehicle traffic crashes. The commonest resulting injury was fractures of the lower limb, and the commonest and cumulatively most expensive injuries presenting at the emergency department were cuts, and sprains and strains. If these costs were extrapolated to New Zealand as a whole it would suggest hospital costs of approximately $457 million per annum; when taken in conjunction with other known medical and welfare costs this approximates to an annual bill to the state of approximately $1.2 billion per annum.

CONCLUSION

Injuries are a significant, costly, potentially preventable, element of health care. The use of hospital data for the allocation of resources to preventive efforts to date, has been based primarily on hospital admission numbers. This study suggests that this is not however indicative of the costs to the state, and the use of financial and other utilisation data would assist in rationalising resource allocation to preventive programs.