Study On The Epidemiological Survey And Economic Burden Of Injuries Among The Residents Of Shandong Province

Objective From the epidemiology and medical economics perspective, to comprehend the current status of injury among the residents of Shandong province, including the incidence, mortality and epidemic characteristics of injury. To find common causes and epidemic factors of injury and quantifying the years of potential life lost (YPLL) and economic burden due to injuries. To lay a foundation to make decision for government at all levels and departments concerned. Methods Based on economic levels, four cities and six counties (boroughs) from different areas (urban and rural) were randomly selected by multi-stage stratified sampling. And two towns (neighborhoods) were randomly selected from each county (borough), two administrative villages (residents' committee) from each town (neighborhoods). 200 families were defined in each village (residents' committee) by simple random sampling, which summed to 24,438 inhabitants. Through household questionnaire, a cross-sectional retrospective study was conducted by unified-trained inquirers among all the family members on injury in 2003.Results The overall incidence rate of injury in 2003 among constant residents was 7.25% in Shandong province, and the standardized incidence rate was 7.31%, higher in the rural than in the urban areas and higher in men than in women. There was higher incidence in all different age groups, most frequently in group aged 5-14 years, and secondly in group aged more than 60 years. Judging by the frequency of varied injuries, the top five causes of injuries were falling/dropping (1.37%), traffic accidents (1.35%), strain (1.08%), collision (0.93%) and animal bites (0.74%), Retiring people and preschool children were the high-risk groups of falling/dropping, youth and middle-aged people (15-44 years) were the high-risk group of traffic accidents. Motor vehicle was the leading pattern to cause traffic crashes, and bicyclistjust followed it (accounting for 25.45% of the total traffic crashes). Multi-logistic regression analysis indicated that female, workers, students and technicians were the major risk factors, while education condition and average individual income of family were the major protective factors. With more education and higher income, the incidence of injury was reducing. In average, 32.31 years of potential life lost, 26.32 work years of potential life lost and 12.59 valued years of potential life lost for each death were caused by injury. There were 1771 injury accidents happened during the year, which led to economic loss of 4,867,900 RMB yuan in total, obviously higher in men (3,703,100 RMB yuan) than in women (1,164,800 RMB yuan). Economic loss for each case with injury (including death) cost 2748.67 RMB yuan. The economic cost of traffic accidents was the largest of all the injuries (accounting for 44.46% of the total); and falling/droping ranked the second (accounting for 23.58% of the total). As to age group, the cost was mostly owed to the age group of 15-44 years (58.22% of the total cost), which followed by the age group of 45-59 years (21.21%). Conclusion The incidence of injury was higher among constant residents in Shandong province, and its economic burden to the individuals and their families was heavier. Injury has become an important public problem harming to people's health in our province. Traffic accidents caused the most economic cost, and falling ranked the next. Young people were the high-risk group of traffic accidents; Students were the most common group of strain, falling and animal bites; and preschool children were injuried mostly from falling and animal bites. It indicated that we should enhance health education and interventions to emphasized population. It was important to protect vulnerable road users (pedestrians, motorcyclists/bicyclists, passengers) in preventing from road traffic injury. Attention must be paid to prevent older people from falling in rural areas. Intervention must be taken to prevent from falling aiming at the groups of more than 60 years old and 5-14 years old. In view of students being the group of highest injury incidence, school should be coordinated with families and health sector to strengthen students' self-protect awareness by enhancing health education, which woulr4 gradually reduce *he huge economic cost and social burden due to emergency, medicine, recovery, an untimely end and disability.