The research, involving academics from The University of Nottingham, used data direct from patient experiences combined with information on the number of patients treated in emergency departments and admitted to hospital to reveal that the true impact of injuries in the UK is actually 2.6 times higher than experts believed.
For the study, published this week in the journal PLoS Medicine, the researchers recruited patients aged over five years old with a wide range of injuries, including fractures and dislocations, cuts, bruises and abrasions, sprains, burns and scalds, and head, eye, chest and abdominal injuries, from hospitals in four English cities — Swansea, Nottingham, Bristol and Guildford — between September 2005 and April 2007.
A total of 1,517 injured people, with an average age of 37.4 years, took part in the study, the majority of whom had suffered an accidental injury in the home. Using the data and information collected from patient questionnaires about their injuries and the effect on their lives, the authors found that in 2005, there were an estimated 750,999 injury-related hospital admissions, 7,982,947 emergency department attendances and 22,185 injury-related deaths. This translated to a rate per 100,000 of the population of 1,240; 13,339; and 36.8 respectively.
The researchers estimated the disability adjusted life years (DALYs), which combine the years of life lost due to premature death and the years of productive life lost due to disability after an injury, to summarise the impact of the injuries. Putting all the information together, the total number of DALYs related to injury was 1,771,486 in 2005, 2.6 times higher than previously thought.
The study was led by researchers from the Centre for Health Information Research and Evaluation, College of Medicine, at Swansea University in Wales and involved academics from the Division of Primary Care at The University of Nottingham, Nottingham, the Centre for Child and Adolescent Health at the University of the West of England, Oakfield House, Bristol, the Centre for Transport Studies at University College London, London and the School of Public Health and Preventive Medicine, Monash University, Victoria in Australia.
Professor Denise Kendrick, lead researcher on the study at The University of Nottingham, said: “While considerable uncertainties remain, our best estimate is that injury-related DALYs are 2.6 times greater than previously thought, and even if we are very conservative and assume that everyone we were unable to follow up had completely recovered from their injury, the estimate of DALYs would still be 1.6 times greater than earlier estimates.”
The researchers believe that, while the study was carried out in the UK, the principal findings are relevant across the globe. The results suggest that if the pattern of underestimation seen in the UK was mirrored across the world, then injuries may account for up to one-quarter of global DALYs rather than one-sixth as previously estimated.
The study concludes that healthcare policy and provision may be grossly inadequate, given they are based on previous estimates of the impact of injury in the UK.
A copy of the paper is available online from the journal PLoS Medicine.
The Nottingham researchers are currently working on another five year study assessing the impact of injuries. This is a collaboration with the Universities of the West of England, Loughborough and Surrey and funded through the National Institute for Health Research (NIHR) Nottinghamshire, Derbyshire and Lincolnshire CLAHRC (Collaboration for Leadership in Applied Health Research and Care).
The study is measuring the impact of injuries on people’s physical, psychological, social and occupational wellbeing at one month, two months, four months and 12 months post-injury. It will also assess health and social care use and costs and quantify the impact of psychological problems on recovery.
The study is recruiting almost 700 patients aged between 16 and 70 years who have been admitted to hospital following an accidental injury from hospitals in Nottingham, Bristol, Leicester and Surrey.
As part of the research, the academics will also be interviewing injured people, representatives from services which help people recover from injuries and carers to explore how well services met their needs and how they might be improved to help injured people make a better, faster recovery.
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