Ten-year health service use outcomes in a population-based cohort of 21 000 injured adults: the Manitoba Injury Outcome Study

Abstract

Objective To quantify long-term health service use (HSU) following non-fatal injury in adults. Methods A retrospective, population-based, matched cohort study identified an inception cohort (1988-91) of injured people who had been hospitalized (ICD-9-CM 800-995) aged 18-64 years (n = 21 032) and a matched non-injured comparison group (n = 21 032) from linked administrative data from Manitoba, Canada. HSU data (on hospitalizations, cumulative length of stay, physician claims and placements in extended care services) were obtained for the 12 months before and 10 years after the injury. Negative binomial and Poisson regressions were used to quantify associations between injury and long-term HSU. Findings Statistically significant differences in the rates of HSU existed between the injured and non-injured cohorts for the preinjury year and every year of the follow-up period. After controlling for pre-injury HSU, the attributable risk percentage indicated that 38.7% of all post-injury hospitalizations (n = 25 183), 68.9% of all years spent in hospital (n = 1031), 21.9% of physician claims (n = 269 318) and 77.1% of the care home placements (n = 189) in the injured cohort could be attributed to being injured. Conclusion Many people who survive the initial period following injury, face long periods of inpatient care (and frequent readmissions), high levels of contact with physicians and an increased risk of premature placement in institutional care. Population estimates of the burden of injury could be refined by including long-term non-fatal health consequences and controlling for the effect of preinjury comorbidity. Voir page 808 le résumé en français. En la página 809 figura un resumen en español.

Assessing global risk factors for non-fatal injuries from road traffic accidents and falls in adults aged 35–70 years in 17 countries: a cross-sectional analysis of the Prospective Urban Rural Epidemiological (PURE) study

“…All eight potential risk factors were included in the multivariable models, one of which was constructed for each type of injury (ie, RTA, falls). Since PURE was designed to be a study of urban versus rural differences in HIC, UMIC, LMIC and LIC,21 the multivariable models contained an interaction term for urban/rural place of residence and socioeconomic region. All analyses were done using SAS V.9.2 (The SAS Institute, Cary, North Carolina, USA) and SPSS V.20.0 (IBM, Armonk, New York, USA).…”

Physical Function and Mental Health in Trauma Intensive Care Patients

“…Probably as a result of this reduced function, injured patients have a greater ongoing use of health services (13) than others in the community (14). Although there is widespread evidence of reduced function during recovery after injury, the predictors of that function are not fully understood.…”

Recovery from injury: the UK Burden of Injury Multicentre Longitudinal Study

“…During 2010/2011, 4.4 million work days were lost in the UK due to workplace injuries alone 14. Societal costs include days lost at work and increased healthcare use15 and consequent costs16 17 as a result of injury.…”