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

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