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Economic Impact of Hand and Wrist Injuries: Health-Care Costs and Productivity Costs in a Population-Based Study

de Putter, C.E., MD1; Selles, R.W., PhD1; Polinder, S., PhD1; Panneman, M.J.M., MSc2; Hovius, S.E.R., MD, PhD1; van Beeck, E.F., MD, PhD1

doi: 10.2106/JBJS.K.00561
Scientific Articles
Supplementary Content

Background: Injuries to the hand and wrist account for approximately 20% of patient visits to emergency departments and may impose a large economic burden. The purpose of this study was to estimate the total health-care costs and productivity costs of injuries to the hand and wrist and to compare them with other important injury groups in a nationwide study.

Methods: Data were retrieved from the Dutch Injury Surveillance System, from the National Hospital Discharge Registry, and from a patient follow-up survey conducted between 2007 and 2008. Injury incidence, health-care costs, and productivity costs (due to absenteeism) were calculated by age group, sex, and different subgroups of injuries. An incidence-based cost model was used to estimate the health-care costs of injuries. Follow-up data on return to work rates were incorporated into the absenteeism model for estimating the productivity costs.

Results: Hand and wrist injuries annually account for $740 million (in U.S. dollars) and rank first in the order of most expensive injury types, before knee and lower limb fractures ($562 million), hip fractures ($532 million), and skull-brain injury ($355 million). Productivity costs contributed more to the total costs of hand and wrist injuries (56%) than did direct health-care costs. Within the overall group of hand and wrist injuries, hand and finger fractures are the most expensive group ($278 million), largely due to high productivity costs in the age group of twenty to sixty-four years ($192 million).

Conclusions: Hand and wrist injuries not only constitute a substantial part of all treated injuries but also represent a considerable economic burden, with both high health-care and productivity costs. Hand and wrist injuries should be a priority area for research in trauma care, and further research could help to reduce the cost of these injuries, both to the health-care system and to society.

1Departments of Plastic, Reconstructive, and Hand Surgery (C.E.d.P. and S.E.R.H.), Rehabilitation Medicine (R.W.S.), and Public Health (S.P. and E.F.v.B.), Erasmus MC Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. E-mail address for C.E. de Putter: Email address for S. Polinder: E-mail address for E. F. Van Beeck:

2Consumer and Safety Institute, P.O. Box 75169, 1070 AD Amsterdam, The Netherlands. E-mail address for M.J.M. Panneman:

Copyright © 2012 by The Journal of Bone and Joint Surgery, Incorporated
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