Medical and work loss costs of violence, self-harm, unintentional and traumatic brain injuries per injured person in the USA

Objective Injuries and poisoning are leading causes of US morbidity and mortality. This study aimed to update medical and work loss cost estimates per injured person. Methods Injuries treated in emergency departments (ED) during 2019–2020 were analysed in terms of mechanism (eg, fall) and intent (eg, unintentional), as well as traumatic brain injury (TBI) (multiple mechanisms and intents). Fatal injury medical spending was based on the Nationwide Emergency Department Sample and National Inpatient Sample. Non-fatal injury medical spending and workplace absences (general, short-term disability and workers’ compensation) were analysed among injury patients with commercial insurance or Medicaid and matched controls during the year following an injury ED visit using MarketScan databases. Results Medical spending for injury deaths in hospital EDs and inpatient settings averaged US4777 (n=57 296) and US45 678 per fatality (n=89 175) (2020 USD). Estimates for fatal TBI were US5052 (n=5363) and US47 952 (n=37 184). People with ED treat and release visits for non-fatal injuries had on average US5798 (n=895 918) in attributable medical spending and US1686 (11 missed days) (n=116 836) in work loss costs during the following year, while people with non-fatal injuries who required hospitalisation after an ED injury visit had US52 246 (n=32 976) in medical spending and US7815 (51 days) (n=4473) in work loss costs. Estimates for non-fatal TBI were US4529 (n=25 792), US1503 (10 days) (n=1631), US51 241 (n=3030) and US6110 (40 days) (n=246). Conclusions and relevance Per person costs of injuries and violence are important to monitor the economic burden of injuries and assess the value of prevention strategies.