Incidence and costs of injuries to children and adults in the United States

Background: Injuries are a leading cause of death and acquired disability, and result in significant medical spending. Prior estimates of injury-related cost have been limited by older data, for certain population, or specific mechanisms. Findings: This study estimated the incidence of hospital-treated nonfatal injuries in the United States (US) in 2013 and the related comprehensive costs. Injury-related emergency department (ED) visits and hospitalizations were identified using 2013 Healthcare Cost and Utilization Project (HCUP) data. Models estimated the costs of medical spending and lost future work due to injuries in 2013 U.S. dollars. A total of 31,038,072 nonfatal injury-related hospitalizations and ED visits were identified, representing 9.8 per 100 people. Hospital-treated nonfatal injuries cost an estimated $1.853 trillion, including$168 billion in medical spending, $223 billion in work losses, and$1.461 trillion in quality of life losses. Conclusions: Approximately one in 10 individuals in the US is treated in the hospital for injury each year, with high corresponding costs. These data support priority-setting to reduce the injury burden in the US

Injury-related mortality among adolescents: findings from a teaching hospital's post mortem data

<p>Abstract</p> <p>Background</p> <p>Injuries are noted to be an important cause of death among adolescents. There is however limited data on the injury related deaths among adolescents in Ghana.</p> <p>Findings</p> <p>Using data from post-mortem records derived from the Department of Pathology of the Korle-Bu Teaching Hospital (KBTH), Accra Ghana from 2001 to 2003, the causes of injury related deaths among adolescents 10 to 19 years were analyzed by gender and age groups 10 to 14 and 15 to 19 years. There were 151 injury-related deaths constituting 17% of the autopsies performed among adolescents in the study period. The male-to-female ratio was 2.1:1. Drowning was the most common cause of death (37%) in the study population. This was followed by road traffic accidents (RTA) (33%). Over 70% of the RTA victims were pedestrians knocked downed by a vehicle. Deaths from electrocution, poisoning, burns, stab/gunshot, hanging and other miscellaneous causes (example blast injury, traumatic injury from falling debris, fall from height) made up the remaining 30% of the injury related mortality. Among males and in both age categories, drowning was the leading cause of death. In females, the highest mortality was from road traffic accidents accounting for almost half (49%) of the deaths; significantly more than that occurring in males (25%, p = .004).</p> <p>Conclusions</p> <p>Findings from Korle-Bu Teaching Hospital post-mortem data on adolescents show that drowning and road traffic accidents are the leading causes of injury-related mortality. Appropriate injury reducing interventions are needed to facilitate a decrease in these preventable deaths.</p

Burden of injury in childhood and adolescence in 8 European countries

Injury is the major cause of death and suffering among children and adolescents, but awareness of the problem and political commitment for preventive actions remain unacceptably low. We have assessed variation in the burden of injuries in childhood and adolescence in eight European countries. Hospital, emergency department, and mortality databases of injury patients aged 0-24 years were analyzed for Austria, Denmark, Ireland, Latvia, Netherlands, Norway, Slovenia and the United Kingdom (England, Wales). Years lost due to premature mortality (YLL), years lived with disability (YLD), and disability adjusted life years (DALYs) were calculated. Differences in the burden of injury in childhood and adolescence are large, with a fourfold gap between the safest countries (Netherlands and UK) in western-Europe and the relatively unsafe countries (Latvia and Slovenia) in the east. Variation between countries is attributable to high variation in premature mortality (YLL varied from 14-58 per 1000 persons) and disability (YLD varied from 3-10 per 1000 persons). Highest burden is observed among males ages 15-24. If childhood and adolescence injuries are reduced to the level of current best injury prevention practices, 6 DALYs per 1000 child years can be avoided. Injuries in childhood and adolescence cause a high disability and mortality burden in Europe. In all developmental stages large inequalities between west and east are observed. Potential benefits up to almost 1 million healthy child years gained across Europe are possible, if proven ways for prevention are more widely implemented. Our children deserve action now

Measuring health-related quality of life for child maltreatment: a systematic literature review

<p>Abstract</p> <p>Background</p> <p>Child maltreatment causes substantial morbidity and mortality in the U.S. Morbidity associated with child maltreatment can reduce health-related quality of life. Accurately measuring the reduction in quality of life associated with child maltreatment is essential to the economic evaluation of educational programs and interventions to reduce the incidence of child maltreatment. The objective of this study was to review the literature for existing approaches and instruments for measuring quality-of-life for child maltreatment outcomes.</p> <p>Methods</p> <p>We reviewed the current literature to identify current approaches to valuing child maltreatment outcomes for economic evaluations. We also reviewed available preference-based generic QOL instruments (EQ-5D, HUI, QWB, SF-6D) for appropriateness in measuring change in quality of life due to child maltreatment.</p> <p>Results</p> <p>We did not identify any studies that directly evaluated quality-of-life in maltreated children. We identified 4 studies that evaluated quality of life for adult survivors of child maltreatment and 8 studies that measured quality-of-life for pediatric injury not related to child maltreatment. No study reported quality-of-life values for children younger than age 3.</p> <p>Currently available preference-based QOL instruments (EQ-5D, HUI, QWB, SF-6D) have been developed primarily for adults with the exception of the Health Utilities Index. These instruments do not include many of the domains identified as being important in capturing changes in quality of life for child maltreatment, such as potential for growth and development or psychological sequelae specific to maltreatment.</p> <p>Conclusion</p> <p>Recommendations for valuing preference-based quality-of-life for child maltreatment will vary by developmental level and type of maltreatment. In the short-term, available multi-attribute utility instruments should be considered in the context of the type of child maltreatment being measured. However, if relevant domains are not included in existing instruments or if valuing health for children less than 6 years of age, direct valuation with a proxy respondent is recommended. The choice of a proxy respondent is not clear in the case of child maltreatment since the parent may not be a suitable proxy. Adult survivors should be considered as appropriate proxies. Longer-term research should focus on identifying the key domains for measuring child health and the development of preference-based quality-of-life instruments that are appropriate for valuing child maltreatment outcomes.</p

Perfil dos atendimentos a crianças e adolescentes vítimas de causas externas de morbimortalidade, 2000-2006 Perfil de la atención a los niños y adolescentes víctimas de causas externas de morbilidad y mortalidad, 2000-2006 Profile of care delivered to children and adolescents victims of external causes of morbidity and mortality, 2000-2006

As causas externas constituem importantes fatores de morbimortalidade infantil e de incapacitações permanentes em todo o mundo. Estudo descritivo, de natureza quantitativa que objetivou caracterizar os atendimentos a crianças e adolescentes, na faixa etária de zero a 19 anos, vítimas de causas externas de morbimortalidade em um hospital universitário do interior de São Paulo, Brasil, no período de 2000 a 2006. Constatou-se no período estudado 6.302 atendimentos, sendo que a maioria dos casos registrados ocorreu entre adolescentes de 15 a 19 anos, no sexo masculino, entre sábado e segunda-feira e das 19 à zero hora. O principal diagnóstico de causa externa foram os acidentes de transporte, seguidos das agressões. Conclui-se que é de fundamental importância o papel da enfermagem na atenção aos acidentes, violências e agressões junto às famílias e comunidade, contribuindo para o planejamento e desenvolvimentos de ações preventivas e assistenciais.<br>Las causas externas se constituyen en importantes factores de morbilidad, mortalidad y discapacidad permanente en todo el mundo. Estudio cuantitativo, descriptivo y transversal, tuvo como objetivo caracterizar la atención de emergencia para niños y adolescentes con edades de cero a 19 años, víctimas de las causas externas de morbilidad y mortalidad en un hospital universitario en el interior del estado de Sao Paulo, Brasil, desde 2000 hasta 2006. Se observó durante el período de estudio 6302 de los casos, y que la mayoría de los casos notificados ocurrieron entre los adolescentes de 15 a 19 años, varones, entre el sábado y el lunes y de 19 a 00 horas. El principal diagnóstico de causa externa fueron los accidentes de transporte, seguido por agresiones. Así, es de importancia fundamental el papel de la atención de enfermería a los accidentes, la violencia y la agresión entre las familias y la comunidad, contribuyendo a la planificación y desarrollo de acciones preventivas y asistenciales.<br>External causes are important factors of child morbidity and mortality and permanent disabilities around the world. This quantitative, descriptive and cross-sectional study aimed to characterize emergency care for children and adolescents aged from zero to 19 years victims of external causes of morbidity and mortality in a university hospital in the interior of the state of Sao Paulo, Brazil, between 2000 and 2006. At the end of the study period researchers found 6302 emergency attendances and the majority of reported cases occurred among adolescents aged 15 to 19 years, males, between Saturday and Monday and from 7 to 12 pm. The main diagnoses of external causes were transport accidents, followed by assault. In conclusion, the nurses' role in caring for patients who are recovering from accidents, violence and aggression is of fundamental importance for the families and community. It is essential in order to contribute to the planning and development of preventive and assistance actions

Exogenic poisoning in children assisted in a pediatric emergency unit Intoxicaciones exógenas en niños atendidos en una unidad de emergencia pediátrica Intoxicações exógenas em crianças atendidas em uma unidade de emergência pediátrica

OBJECTIVE: To describe the epidemiological characteristics of all exogenic poisoning cases in children assisted in a pediatric emergency unit in Recife, State of Pernambuco, Brazil, from April to September 2006. METHODS: This is a descriptive study of exogenic poisoning in 0-12 aged children treated at Centro de Assistência Toxicológica de Pernambuco (Pernambuco Toxicological Assistance Center). The data were collected through interviews and by consulting patients' records. RESULTS: 26 cases of accidental exogenic poisoning were registered, mainly males (65.4%). Regarding age, children under five years old were the most affected (65.4%). Medication was involved in 50.0% of the cases. CONCLUSION: Accidental exogenic poisoning affecting children younger than five years of age stands out as a significant public health problem. As a member of a multiprofessional health team, the nurse plays an important role in health education and in the measures to prevent child poisoning.<br>OBJETIVO: Describir las características epidemiológicas de los casos de intoxicaciones exógenas en niños atendidos en una unidad de emergencia pediátrica de Recife (PE), en el período de abril a setiembre del 2006. MÉTODOS: Se trata de un estudio descriptivo de los casos de intoxicaciones exógenas ocurridos en niños del grupo etáreo de 0 a 12 años de edad notificados en el Centro de Asistencia Toxicológica de Pernambuco. Los datos fueron recolectados a través de entrevistas y consultas a las fichas de atención hospitalaria. RESULTADOS: Fueron registrados 26 casos de intoxicación exógena accidental. Predominó el sexo masculino (65,4%) siendo el grupo etáreo de menores de cinco años de edad el más afectado (65,4%). Los medicamentos estaban involucrados en el 50,0% de los casos. CONCLUSIÓN: La intoxicación exógena accidental de niños, sobre todo en menores de cinco años es un problema de salud pública que requiere medidas preventivas para evitar que ocurra en la infancia.<br>OBJETIVO: Descrever as características epidemiológicas dos casos de intoxicações exógenas em crianças atendidas em uma unidade de emergência pediátrica do Recife (PE), no período de abril a setembro de 2006. MÉTODOS: Estudo descritivo dos casos de intoxicações exógenas ocorridos em crianças na faixa etária de 0 a 12 anos de idade notificados no Centro de Assistência Toxicológica de Pernambuco. Os dados foram coletados através de entrevistas e consultas às fichas de atendimento hospitalar. RESULTADOS: Foram registrados 26 casos de intoxicação exógena acidental. Predominou o sexo masculino (65,4%) e a faixa etária dos menores de cinco anos de idade foi a mais acometida (65,4%). Os medicamentos estavam envolvidos em 50,0% dos casos. CONCLUSÃO: A intoxicação exógena acidental de crianças, sobretudo em menores de cinco anos é um problema de saúde pública que requer medidas preventivas para evitar sua ocorrência na infância