The impact of injuries on health service resource use and costs in primary and secondary care in the English NHS

Background Injuries in working age adults are common, but few studies examine NHS resource use or costs. Methods Costing study based on a cohort of 16- to 70-year olds admitted to hospital following unintentional injury in NHS Trusts in four UK centres. Participants completed resource-use questionnaires up to 12 months post-injury. Primary and secondary care, aids, adaptations, appliances and prescribed medications were costed. Mean costs by injury type and age group and costs per clinical commissioning group (CCG) were estimated. Results A total of 668 adults participated. Follow-up rates ranged from 77% at 1 month to 65% at 12 months. The mean cost of injuries over 12 months was £4691 per participant. Costs were highest for hip fractures (£5159), lower limb fractures (£4969) and multiple injuries (£4969). Secondary care accounted for 87% of mean costs across all injuries and primary care for 10%. The mean cost per CCG was £7.3 million (range £1.8 million–£25.6 million). The total cost across all English CCGs was £1.53 billion. Conclusions Unintentional injuries in working age adults result in high levels of NHS resource use and costs in the year following injury. Commissioning effective injury prevention interventions may reduce these costs.