Consumer product-related injury in Australia: direct hospital and medical costs

Abstract

This research was carried out on behalf of the Australia National Audit Office to obtain an estimate of the direct hospital and medical treatment costs of consumer product-related injury in Australia.

Overall, it is estimated that there are almost 5.5 million cases of consumer product-related injury seeking medical attention annually with over 238,000 of these requiring hospitalisation and over 4,000 resulting in death. It is estimated that almost half a million of these cases were related to product failure or malfunction with 18,000 of these requiring hospitalisation and 200 resulting in death.

The direct hospital and medical treatment of all non-intentional consumer product-related injury in Australia is estimated to cost at least $A i 355 million annual ly. This includes treatment costs of injury associated with product failure or malfunction of at least $A95 million.

The Commonwealth government of Australia bears most of this burden through its support of State hospital systems and the universal health insurance scheme Medicare. The report concludes that the high cost of medical and hospital treatment of consumer product-related injury indicates the need to undertake a coordinated program aimed at reducing the frequency and severity of such injury and makes several recommendations particularly in relation to data collection and the dissemination of information in the area of consumer product safety in Australia.     

Characteristics and risk factors for accident injury in Canada from 1986 to 1996: an analysis of the Canadian Accident Injury Reporting and Evaluation (CAIRE) database

This study analyzed the database of Canadian Accident Injury Reporting and Evaluation (CAIRE) for the injuries reported from January 1986 to March 1996 in seven provinces at children's or general hospitals in Canada. In order to describe the characteristics of injuries, we compared the different categories of injuries by sex and by age groups, identified patterns of injuries, and detected the products causing injury to Canadian people. The results showed that there were 130,489 injury cases in Canada during the 10 years from 1986 to 1996. The 10–19 year age group had 57,582 cases, representing 44.13% of total injuries, and making it the group with the highest occurrence of injuries. The male injury rate (69.75%) was significantly higher than the female rate (30.25%) (P = 0.0001). Six areas were identified as priorities for intervention: 1) injuries occurring on playgrounds among children and youth; 2) sports and playground apparatus injuries and injuries sustained in transit among young people; 3) the top five causes of injuries; 4) diagnosis and treatment of injuries; 5) consumer products and safety; and 6) nature and physical sites of injuries. Further work is needed in: evaluating injury causes, comparing the results with reports from other countries and the necessary approaches and prevention measures to reduce and control injury occurrences to improve the quality of consumer products, and to protect the health of the population in Canada.     

New directions in injury surveillance: Development of a model for continuous monitoring of direct medical costs

Information on the costs of injuries is an important additional instrument in setting priorities for injury prevention. The importance of this instrument is increasingly being recognized by health policy makers. The objective of this study was to develop a model which continuously monitors the direct medical costs of injuries in The Netherlands. This model should provide information on the direct medical costs of injuries at any time and for any selection of injury categories. It is an incidence-based model according to the ‘bottom up’ principle. Homogeneous patient groupings with respect to health care use are defined. The groupings are based on existing classifications from the literature and the experience of medical experts, and are defined by means of seven criteria: nature of care provided, body region of the injury, type of injury, severity of injury, age, complications, and sex of the patient. Several cost elements are distinguished (e.g., general practitioner help, hospital care, nursing home care). For each cost element, relevant patient groupings are determined. The new Dutch Injury Surveillance System (LIS) for injuries treated in an A&E department is an important source for incidence data. This article presents the design of the model as adopted by the Working Group on the Costs of Injuries of the European Consumer Safety Association (ECOSA).     

Quantitative risk analysis

Problem. Each year, unsafe consumer products are involved in millions of injuries and thousands of fatalities around the world. There is a need to quantitatively assess the risks to consumers posed by all types of consumer products. Objective. Quantitative Risk Analysis (QRA) is a scientific methodology that was developed to quantitatively demonstrate the potential risk associated with any given consumer product. QRA is based on the Risk Equation which is Risk = Hazard X Exposure. Methods. Key factors affecting Risk were studied. Factors impacting Hazard include Design Defects, Manufacturing Defects, and Foreseeable Use. Factors impacting Exposure include Product Quantity in distribution, Product Durability, Caregiver Vigilance, and Product Accessibility. Monte Carlo Simulation methods were utilized to generate estimates of product-related risk. Results. The Kinder Egg is used as an example and the QRA results for this product in the North American market are presented. Conclusion. QRA results can do the following: 1.) Determine if a design meets desired or necessary safety expectations 2.) Allow one to understand which components of a given design can be modified to ensure the greatest improvements in the safety of a given product 3.) Guide the development of product safety specifications and requirements and 4.) Determine if a recall is warranted. QRA can benefit risk managers and others by allowing them to identify the critical factors influencing the risks posed by consumer products in the global marketplace.     

Product-related injuries at home

Abstract

The current study was undertaken in order to highlight the most typical circumstances and products related to home injuries and to establish the extent to which any patterns found in domestic injuries were age or gender related.

Injury data were taken from a community-based injury surveillance register built up over a one-year period in a Swedish county. Injury incidence by gender and age was calculated, and typical injury patterns were identified through the multivariate analysis of nine characteristics of the injuries.

Home-injury incidence was found to be higher for males than females in all younger age categories except 7-15 years, and for females than males in the oldest age category (65+). Seven typical injury patterns were identified, and their associations with age group and gender established.

The patterns emerging from the study demonstrate that injuries in home settings are simultaneously product, age and gender related, which points to a combination of risk groups and safety planning problems. The results suggest that home injuries are incurred in many specific locations and under a wide variety of circumstances. Accordingly, the question of safety promotion at home needs to be addressed in a global and environmental manner. It is necessary to reflect on the ways in which domestic building structures, items of equipment and products can be designed so as to be conducive to domestic safety.     

Study of kite string injuries in Western India

A prospective analysis of 104 patients (outdoor and indoor) with manja (powdered glass coated kite string) injury from January 2011 to January 2015 was carried out at Civil Hospital Ahmedabad. All patients were analysed for mode and severity of injury, site of injury, associated injuries, activity being performed when injury occurred, the clinical diagnosis and treatment required. Analysis of collected data revealed that majority of the injuries occurred while driving or in pedestrians with the neck being the most commonly affected body part. Males were more commonly affected with most of the victims in the age group of 16–45 years. Injuries sustained while driving tended to be more severe. All injuries were recorded in the month of January. No deaths were reported, but potentially fatal injuries did occur. Most of the injuries were superficial and could be prevented or mitigated by either protective clothing or by use of protective devices on vehicles, which should be implemented to reduce the morbidity of such injuries in the future. There were no ethical issues or vested interests associated with the study.     

Consumer learning, switching costs, and heterogeneity: A structural examination

This paper develops and estimates a model of forward-looking consumer learning with switching costs using household level scanner data from a frequently purchased product category. This is novel because current models of consumer purchase behavior assume that only one of these types of dynamics is present, not both at the same time. My model estimates support the presence of both learning and switching costs in this product category. The estimates show that before consuming new products, consumers are unsure of their tastes for them, and subsequently learn their tastes by purchase and consumption of new products. Switching costs are large, comprising roughly 30 percent of the cost of a medium sized package of the product. Additionally, the model incorporates very rich individual level unobserved heterogeneity in price sensitivities, tastes, and switching costs, and the amount by which consumers learn. To show that my model produces different implications than a model with learning or switching costs only, I estimate two more specifications, one without each type of dynamics, and simulate counterfactuals that are of interest to managers and policymakers. I find that intertemporal elasticities are underestimated when either type of dynamics is left out, by as much as 90%. Informative advertising is also affected by the presence of switching costs, although the direction of the bias is not signed. Leaving out dynamics also has a large impact on long-term elasticities, which are used by antitrust policymakers to evaluate the impact of mergers. When learning is ignored, cross elasticities are underestimated by as much as 45%. When switching costs are ignored, both own and cross elasticities are underestimated.     

Effects of ethyl alcohol on injuries severity according to injury severity scales in pedestrian fatal injury in traffic crashes

Abstract

Introduction: The dominant cause of injuries in traffic crashes. A significant portion of them affects victims under the influence of ethyl alcohol. The goal of the studies was to assess the correlation between the state of sobriety and the severity of injuries expressed by injury severity scales in fatal pedestrian victims of traffic crashes. Research Material and Method: The data were obtained from the Warsaw Medical University's Department of Forensic Medicine. The analysis covered the data for 2009–2013 and included 200 fatal pedestrian victims hit by passenger cars. The assessment of the effect of risk factors on injury severity expressed in terms of injury severity scales such as Life Threat Indicator (LTI), International Classification based Injury Severity Score (ICISS), Injury Severity Score (ISS) and New Injury Severity Score (NISS), was made using adequately selected methods of statistical analysis. Results: As alcohol concentration increases in women, the values of LTI, ICISS-10 and ICISS-15 decrease, which denotes more severe injuries. In the ISS and NISS, the effect of alcohol concentration on the severity of injuries turned out to be negligible. However, these injuries are significantly heavier in women than in men. According to all the scales used, the older the victims, the milder injuries cause their death. Conclusions: The studies show that ethyl alcohol concentration may harm injury severity, especially in the case of women. The assessment of the severity of injuries in traffic crash victims is significantly influenced by their age and gender. The more risk factors the scale takes into consideration, the more precise is the assessment.     

Cost Benefit Analysis of Consumer Product Safety Standards

This paper investigates the role of cost-benefit analysis in evaluating consumer product safety standards and applys such analysis to an evaluation of flammability standards for children's sleepwear. The cost of safety standards includes the costs of standard development and enforcement and the changes in producer and consumer surpluses due to product regulation. The benefits from safety standards are the reduction in product accidents and the direct and indirect costs of such accidents. The cost of the O-6X Children's Sleepwear Standard was based on the change in consumer surplus since it was assumed that supply was perfectly elastic. The benefits were due primarily to the reduction in burn injuries. Cost-benefit ratios ranged from 0.62 to 0.84 assuming that the standard provided 100% protection. The cost-benefit ratios also indicate the degree of protection required by the standard. Thus a ratio of 0.62 implies that 62% protection is required if benefits are to equal costs.     

Exploring clinical metrics to assess the health impact of traffic injuries

In order to allow a deep knowledge of the nonfatal injuries, recently the European Commission adopted the maximum abbreviated injury scale classification which is based on medical diagnosis. This classification will open the door to a new source of information based on international hospital data such as diagnosis-related group and international classification of diseases. In this study, we seek to explore these clinical metrics, which are used to describe the diagnosis and the medical treatment, and to infer consequences of crashes mainly through the costs and severity. Therefore, statistical analyses were applied using generalized linear models selected depending on the type of response variable, i.e. discrete or continuous. Relationships between these metrics were identified revealing for instance that head is the region of the body associated with high severity as well as to higher health care costs. Additionally, a discussion is presented regarding study results and future developments of clinical metrics are pointed out.     

Costs of unintentional injuries among children in an urban slum community in Kampala city,Uganda

Abstract

Unintentional injuries cause deaths, disabilities, productivity and financial losses and disproportionately affect children in low-income settings yet their cost remains under studied. This study determined the household out-of-pocket expenditure and missed school attendance due to unintentional childhood injuries in a Ugandan slum. We used a cross-sectional household survey design. Data were collected on occurrence and associated costs of unintentional injuries during a one-year period from July 2014 to June 2015. A total of 706 (44.7%) children who had suffered from injuries were reported in the one year period. More male children (N?=?415, 58.7%) suffered injuries than females (N?=?291, 41.2%). The average out-of-pocket expenditure on treating an injury was US $24.1 [standard deviation (SD)?=?±$62.8] and mean school days lost were 25 days (SD?=?±51.8). Road traffic injuries (RTIs) resulted in higher costs [mean difference was US $51.1 (95% CI: $11.4–$90.8)] compared to injuries that, for example, occurred at school. In a Ugandan slum community, unintentional childhood injuries resulted in high out-of-pocket expenditures and missed school attendance. The costs varied widely depending on external causes of the injury. These findings highlight the need to invest in population level injury prevention interventions to reduce injury costs by households.     

Skiing and snowboarding injuries and their impact on the emergency care system in South Tyrol: a restrospective analysis for the winter season 2001–2002

Objectives. To evaluate the incidence and the pattern of skiing and snowboarding injuries in South Tyrol and their impact on the emergency medical system in the winter season 2001–2002 in an attempt to rationalize and improve the emergency care and assist in prevention strategies.

Methods. All medical records of patients referred to our emergency department (ED) that sustained a skiing or snowboarding injury during the study period were retrospectively reviewed. Age, sex, local or non-local residency, type of injury, data and time of accident, type of transport to the hospital, hospital admission or ED discharge, Injury Severity Score, outcome (including mortality) were evaluated. On site mortality data were obtained from the emergency call-center registry. Ski resorts utilization was estimated from the data published by the Regional Office of Cable Transport.

Results. For the period analyzed approximately 2,500,000 skier and snowboarder days were recorded in the whole region of which about 500,000 were attributed to the four nearby ski resorts that refer to our hospital. Of the 1087 patients, 794 were skiers and 294 were snowboarders. Snowboarders were younger than skiers (mean age 20 and 36 respectively, p = 0.001). Females were equally represented in the two groups. Male patients, children, senior skiers and non-local residents suffered from more severe injuries than their corresponding classes (p < 0.01, p = 0.002, p = 0.02, p = 0.000 respectively). Critical injuries (ISS ≥ 25) were homogeneously spread in the groups, with the exception of the non-local resident patients that showed a higher incidence (p < 0.02). No difference in severity was found between skiers and snowboarders. The incidence was 2.05 per 1,000 skier-days. Mortality rate was 1.6 per 1,000,000 skier-days. The pattern of injury was different: snowboarders showed more forearm and wrist trauma and skiers more lower extremity injuries. 208 patients were hospitalized and the mean length of stay was 4.5 days. Head trauma and fractures were the most common diagnosis of admission. The lack of field triage led to 12% of unjustified helicopter transfer and 9.6% of avoidable ambulance transport.

Conclusions. Incidence, pattern of injuries and mortality from skiing and snowboarding accidents in South Tyrol resemble those reported in other part of the world. Nevertheless, strategies for prevention are needed. The routine use of helmets should be enforced by law. Dangerous behaviors should be prosecuted. Skiers and snowboarders should be made aware that skiing beyond their technical ability can be life-threatening.     

Hot surface temperatures of domestic appliances

Background Domestic appliances are burning people. In the European Union, accidents requiring hospital treatment due to burns from hot objects account for between 0 and 1% of all such accidents. Young children are particularly at risk. These reported accidents requiring hospital treatment are also likely to be a small proportion of the total number of burns from hot objects. Research method There is a lack of hard evidence about the level of accidents, typical consumer expectation and use, and on the state of the art of appliances. Results of technical laboratory tests carried out on products are used to demonstrate the state of the art and also show how consumer expectations could be changing. Results of a survey into accidents, based on a written questionnaire following telephone contact, provide information on non-hospital cases. Results Results of tests on products show that there are significant differences in the temperatures of touchable surfaces, even in products of the same type. Typically, these differences are due to variations in design and/or materials of construction. Some products are hot enough to burn skin. Accident research indicates that non-hospital medical practices are treating burn injuries, which are therefore not being included into the current accident statistics. Conclusions ? For products with the same function, some types of design or materials of construction are safer, with lower surface temperatures. Many product standards have no or unnecessarily high limits on surface temperatures. ? Many standards do not address the realities of who is using their products, for what purpose or where they are located. Some standards use unreasonable general limitations and exclusions that allow products with higher surface temperatures than they should have. ? Many standards rely on the experience factor for avoiding injury that is no longer valid, with the increased availability of safer products of the same type. A major field of work ahead is to carry out more surveys and in-depth studies of non-fatal accidents and injuries.     

The employer costs of motor vehicle crashes

The latest published estimate of the cost of US motor vehicle crashes to employers is for 1989. This study estimates annual employer costs in 1998-2000. Incidence was estimated with occupational injury data and motor vehicle crash data for 1998-2000. Employer costs were estimated from Federal estimates of crash costs by source of payment using data on the percentage of varied payment streams (e.g. health insurance, sick leave) paid by employers. Motor vehicle crash injuries on and off the job cost employers almost $60 billion annually, including $16.3 billion in fringe benefit costs; $25.2 billion in property damage, workplace disruption and other non-fringe costs; and $18.4 billion in wage-risk premiums. Traffic safety programmes can reduce the fringe benefit bill without reducing the benefits offered to employees. Eliminating alcohol-impaired and unrestrained driving would save employers $15.2 billion annually.     

Impact of youth injuries on the uninsured farm family's economic viability

The objective of this study is to estimate the impact of youth injuries on the uninsured farm family's economic viability. Using farm prototypes, we compared farm profits with costs of farm youth injuries. We built profit models for two types of farms, dairy and soybean farms. Then we estimated the cost impact of farm youth injuries of different levels of severity on a farm family with no health insurance. A severe child injury that requires at least 10 days of hospitalisation would cost almost equal to the operating profit of the average dairy farm with no health insurance and would turn the operating profit of the average soybean farm into a severe loss of $99,499. Prevention of child agricultural injuries would significantly improve the financial situation for farm families that lack health insurance.     

Socio-economic differentials in injury risk

The aim was to highlight the role of childcare products as causes for mild brain injury (concussion) in small children (0-4 years of age) and to determine the most dangerous products. By childcare products this report means the following items: child and baby furniture, nursing tables, baby walkers, toys, baby carriages, sport equipment for children, playground equipment and security equipment for children. The data were derived from the EHLASS (European Home and Leisure Accident Surveillance System) for 1998 and 1999 and covered a restricted population of Sweden (approximately 5 per cent). According to this register 182 mild brain injuries (concussions) were recorded following a fall, an accident or a blow to the head among children (0-4 years of age) during 1998 and 158 for 1999. Of those injuries, childcare products were the cause of the accident in 84 (46 per cent) and 76 (48 per cent) cases respectively for 1998 and 1999. The number of children admitted for hospital care was 68 (57/84) and 74 (56/76) per cent respectively. The home was the most common place of the accident and play and leisure activity were the most common activities. More than 50 per cent of these accidents took place during daytime. The product type that caused most accidents was nursery furniture and, in this category, the baby walker was the most dangerous. The product type that caused the second most frequent accidents was playground equipment.     

Inadequate Life?Evidence of Consumer Attitudes to Product Obsolescence

Public interest in the durability of household appliances may be traced back 40 years to criticism of planned obsolescence raised by an emerging consumer movement. A recent revival of interest in product life spans has taken place in the context of increasing waste generation and debate prompted by proposed producer responsibility legislation, but data on the age of discarded products and consumer attitudes to product life spans have been lacking. This paper draws upon recent data from research into discarded household appliances in the UK to enhance a theoretical model of product obsolescence and explore some implications for marketing and public policy. A survey of over 800 households provided quantitative data on consumer attitudes and behaviour relating to appliance life spans and a subsequent series of focus groups enriched this data with personal narratives. Respondents were evenly divided on whether or not appliance life spans are adequate. Variations in behaviour demonstrated how users may influence appliance life spans. Overall, the results suggest that consumers have an important role in reversing the trend toward increased appliance waste but currently face economic disincentives and lack adequate product information.