Email updates

Keep up to date with the latest news and content from BMC Public Health and BioMed Central.

Open Access Research article

Trends in incidence and costs of injuries to the shoulder, arm and wrist in The Netherlands between 1986 and 2008

Suzanne Polinder1, Gijs IT Iordens2, Martien JM Panneman3, Denise Eygendaal4, Peter Patka25, Dennis Den Hartog2 and Esther MM Van Lieshout2*

Author Affiliations

1 Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands

2 Department of Surgery-Traumatology, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands

3 Consumer & Safety Institute, P.O. Box 75169, 1070 AD Amsterdam, The Netherlands

4 Department of Orthopaedic Surgery, Upper Limb Unit, Amphia Hospital, P.O. Box 90158, 4800 RK Breda, The Netherlands

5 Department of Emergency Medicine, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands

For all author emails, please log on.

BMC Public Health 2013, 13:531  doi:10.1186/1471-2458-13-531

Published: 1 June 2013

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords:
Elderly; Fracture; Health care cost; Incidence; Registry; Upper extremity