the economic burden of injury in ontario dr. philip groff director, research & evaluation...
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The Economic Burden of Injury in Ontario
Dr. Philip GroffDirector, Research & Evaluation
SMARTRISK
SMARTRISK Learning SeriesOctober 17, 2006
The Human Cost of Injury
Partners
• SMARTRISK
• The Hygeia Group
• Health Canada
• Emergency Health Services Branch -- Ministry of Health and Long-Term Care
• Kingston, Frontenac and Lennox & Addington Health Unit
Canada1995
Manitoba2004
British Columbia2001
Atlantic Canada2003
Alberta2002
Saskatchewan2001
Ontario1999
Economic Burden Studies
P.E.I .Ont.
N.S.N.B.
Nvt.
Man.
Alta.
Y.T.
B.C.
N.W.T.
Que.
N.L.
$2.9billion
520PYLL
$819million
961PYLL
$595million
1054PYLL
$1.8billion
925PYLL
$502million
963PYLL
$74million
837PYLL
$372million
646PYLL
n/a
674PYLL
$213million
582PYLL$2.1
billion
920PYLL
n/an/a
n/an/a
n/an/a
Sask.
Burden of Injury Across Canada
Burden of Injury Across Canada
A New Ontario Study
• Update the numbers and methodology
• Include costs for intentional injury
• Breakdowns by Region and LHIN
• Focus on Alcohol
• Focus on Physical Activity
Thanks• The Hygeia Group
• Ministry of Health & Long Term Care
• Ministry of Health Promotion
• Canadian Institute for Health Information
• CAMH / APOLNET
• SMARTRISK Staff
The Electronic Resource Allocation Tool (ERAT)
• Spreadsheet workbook in MS Excel format
• Allows Incidence Costing• In 1999 Dollars• Based upon Provincial Data / Ratios
Incidence Costing
• Costs of injury over the life-course charged to the year of the injury incident– Contrast with Prevalence Costing
• Chosen because of the focus on injury prevention
• Ability to evaluate cost savings from a variety of potential prevention initiatives specific scenarios in this study
Direct and Indirect Costs
Direct Costs
• All costs to the health care system.
Indirect Costs
• Lost productivity due to death and disability.
Causes of Injury Death
Falls29%
Suicide25%
Other21%Violence
3%
Motor Vehicle
22%
Total Deaths4,044
Total Deaths4,044
Ontario 1999Ontario 1999
Causes of Injury Hospitalization
Falls50%
Other24%
Violence3%
Suicide12%
Motor Vehicle
11%
Total Hospitalized
75,176
Total Hospitalized
75,176
Ontario 1999Ontario 1999
Causes of Non-Hospitalized Injury
Falls38%
Other29%
Suicide15%
Violence2%
Motor Vehicle
16%
Ontario 1999Ontario 1999
Total Non-Hospitaliz
ed492,438
Total Non-Hospitaliz
ed492,438
Injury Deaths
Hospitalized
Injuries
Non-hospitaliz
ed Injuries
Injuries Resulting in Partial
Permanent
Disability
Injuries Resulting in Total
Permanent
Disability
Total Annual
Cost
4,04475,17
6492,4
3820,69
31,426
$5.7Billion
Summary of All InjuryOntario, 1999
Direct and Indirect Costs
1,421
421342
91
748
525
694
544
139
809
0
500
1,000
1,500
2,000
Falls
Motor Vehicle
SuicideViolenceOther
$ Millions
Indirect CostsDirect Costs
Ontario, 1999
Costs of Unintentional Falls
154 66274
927
15776
257
35
0
250
500
750
1,000
0-1415-2425-5455+
Age Group
$ Millions
Indirect Costs
Direct Costs
Ontario, 1999
548
384489
137243 105
0
250
500
750
1,000
Same Level
One Level To Another
Other
Type of Fall
$ Millions
Costs of Motor Vehicle Traffic Collision
265
58 12
365
8142 123
1424
170
250
500
750
Driver/Passenger
PedestrianMotorcyclistPedal Cyclist
Other
Injured Party
$ Millions
Indirect CostsDirect Costs
Ontario, 1999
Costs of Intentional Injuries
Interpersonal Violence
4642
28 960
257130
125
250
375
500
Fight, brawl, sexual assault
Cutting / PiercingChild battering
Other
Cause of Injury
$ Millions
Indirect CostsDirect Costs
Ontario, 1999
Suicide and Self-Inflicted
274
184
17735 148
1542110
125
250
375
500
Poisoning
Hanging, Strangulation, Suffocation
Cutting / Piercing
Other
Cause of Injury
$ Millions
Injury Deaths
Hospitalized Injuries
Non-hospitalized Injuries
Injuries Resulting in Partial
Permanent
Disability
Injuries Resulting in Total
Permanent
Disability
Total Annual
Cost
192 6,999 53,434 2,134 157$655Million
Injuries Resulting from Physical Activity
Ontario, 1999
Costs of Injuries Resulting fromPhysical Activity
83
6454
83
87
56
29
19
5
87
29
59
0
50
100
150
200
Sport collision
Walking
OverexertionPedal CyclingPlayground FallWater Sport
Type of Physical Activity
$ Millions
Indirect CostsDirect Costs
Ontario, 1999
Type of Injury % Deaths% Hospitalized
Injuries
% Non-hospitalized
InjuriesMotor Vehicle
Traffic Collisions
23 13 10
Unintentional Falls 7 6 6
Suicide and Self-Inflicted
Injury14 12 12
Interpersonal Violence 25 22 22
Estimated Cases of Injury with
Alcohol InvolvementOntario, 1999
Costs of Injuries Associated with Alcohol
43
85
20
113
32
74
41 32
0
50
100
150
200
MVC FallsSuicide Violence
Type of Injury
$ Millions
Indirect CostsDirect Costs
Ontario, 1999
$1 spent on… Saves
painting traffic lines on roads $61
front seat belts $49
functional family therapy for juvenile delinquents
$32
smoke detectors $15
comprehensive fall prevention programs for community-dwelling, high risk seniors
$ 7
Big Brother/Sister mentoring for violence prevention
$ 5
intensive sobriety checkpoints $ 3
Injury Prevention Cuts Costs
Five Prevention Scenarios
•20% reduction in falls among 55+
•20% reduction in falls among children <15
•30% reduction in MVC
•20% reduction in self-inflicted poisoning
•20% reduction in interpersonal violenceTotal combined savings of $500 Million
annually
One Prevention Scenario:Falls Among Seniors 55+• In 1999 $927 million attributed to direct
costs of falls among those 55+
• The proportion of Ontarians ages 65+ will nearly double by 2031, rising to 24%
• Existing strategies have been demonstrated to reduce falls among seniors by 20%
• 4,000 fewer hospital stays
• 1,000 fewer seniors disabled
• $121 million reduction in direct health care costs
Conclusion
•Ontarians bear a heavy burden
•This burden is not static, there is a cost to inaction
•Proven approaches to prevention exist
•Ontario needs to tackle the burden of injury in a strategic way
www.smartrisk.ca
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