Hartling L, Pickett W, Dorland J, Brison R J
Department of Community Health and Epidemiology, Queen's University at Kingston, Ontario, Canada.
Am J Ind Med. 1997 Nov;32(5):502-9. doi: 10.1002/(sici)1097-0274(199711)32:5<502::aid-ajim10>3.0.co;2-6.
To assist those responsible for agricultural safety, we: (1) piloted an approach to costing hospitalized farm injuries; and, (2) described ambulance and inpatient costs associated with these injuries in Ontario. Hospital discharge records (hospital separations) for farm machinery injuries in Ontario (n = 1,610) were identified by ICD9-CM E-codes for 1985-1993. Ambulance costs were estimated by the Ontario Ministry of Health. For each case, the hospital costs were calculated by multiplying the case-specific resource intensity weight by the average inpatient cost per weighted case. The costs (1993 Canadian dollars) ranged from $768 to $62,643 and totaled $6.9 million over the study period. Males accounted for 89.8% of the total costs. Tractor injuries accounted for a large proportion of costs (34.3%). The median costs per case varied by type of machinery, ranging from $2,043 for ploughs/disks to $3,366 for augers. Entanglement injuries were responsible for the largest proportion of costs (40.7%), while tractor rollovers accounted for the highest median cost ($3,065). Although these figures represent a fraction of the total costs associated with farm injuries, the results provide one basis from which to justify and target preventive initiatives. This approach to costing may also be widely applicable to other health issues.
为帮助那些负责农业安全的人员，我们：（1）试点了一种计算因农业受伤而住院的成本的方法；以及（2）描述了安大略省与这些伤害相关的救护车和住院费用。通过1985 - 1993年国际疾病分类第九版临床修正本（ICD9 - CM）电子编码，确定了安大略省（n = 1610例）农场机械伤害的医院出院记录（医院离院情况）。救护车费用由安大略省卫生部估算。对于每一个病例，通过将特定病例的资源强度权重乘以每个加权病例的平均住院费用来计算医院费用。这些费用（1993年加拿大元）从768加元到62643加元不等，在研究期间总计690万加元。男性占总费用的89.8%。拖拉机伤害占费用的很大比例（34.3%）。每个病例的费用中位数因机械类型而异，从犁/圆盘耙的2043加元到螺旋输送器的3366加元不等。卷入伤害造成的费用比例最大（40.7%），而拖拉机翻车造成的中位数费用最高（3065加元）。尽管这些数字仅占与农业伤害相关的总成本的一部分，但研究结果为证明预防措施的合理性并确定其目标提供了一个依据。这种成本计算方法也可能广泛适用于其他健康问题。
