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CDC Study Finds Costs Much Higher for Intentional Injuries Treated in EDs

ATLANTA – The vast majority, 90%, of injuries treated at U.S. emergency departments are unintentional, but the costs per case were 57% higher for injuries resulting from assaults and 71% higher for injuries resulting from self-harm, according to a new study from the CDC.

The report, published recently in the Morbidity and Mortality Weekly Report, tallies the costs of ED-treated injuries for the U.S. healthcare system, as well as the substantial price tag for lost work days in 2013.

The rate of hospitalized injuries was 950.8 per 100,000, according to the analysis, and the rate of treated and released injuries was 8,549.8 per 100,000. The total cost of all ED-treated nonfatal injuries was $456.9 billion, according to the CDC.

Unintentional injuries accounted for $253.5 billion in lifetime costs, or about 87% of costs for hospitalized injuries, while assault injuries and self-harm injuries made up $26.4 billion and $11.3 billion of lifetime costs, respectively.

Interestingly, the researchers found a large age gap between intentional and unintentional injuries.

“Costs for hospitalized violent injuries were concentrated among adults aged 15-44 years, with 72% of costs for assaults and 67% of self-harm costs accounted for by these age groups,” the CDC authors write. “In contrast, adults aged ≥45 years accounted for 59% of costs associated with hospitalized injuries that were unintentional.”

For all ED-treated nonfatal injuries, 37% of costs were associated with injuries from falls and 21% from transportation-related injuries, such as automobile accidents. Only 2.6% of nonfatal injury costs were related to poisoning, yet, among fatal injuries, drug poisonings accounted for the highest percentage of costs, 27.4%.

“Although nonfatal injuries treated in EDs are common and costly, appropriate implementation of evidence-based strategies can reduce nonfatal injuries from the mechanisms that lead to the greatest cost burden,” study authors write. “For example, primary seat belt laws, motorcycle helmet laws, sobriety checkpoints, and alcohol interlocks are effective in preventing motor vehicle-related injuries and can produce substantial economic benefits that greatly exceed the implementation costs.”

They also suggest that the ED might be an ideal setting for promoting prevention: “Studies of some screening and brief intervention programs for reducing excessive alcohol use, which is a risk factor for both unintentional and violent injuries, have shown that this intervention can reduce the likelihood of a subsequent visit to the ED for injury or violence-related causes.”