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.