Methodological issues in comparing injury incidence across countries

The primary objective was to describe the methodological challenges and devise solutions to compare injury incidence across countries. The research design was a mixed methods study, consisting of a consultation with an expert group and comparison of injury surveillance systems and data from ten European countries. A subset of fractures, selected radiologically verifiable fractures and a method of checking the national representativeness of sample emergency department data were devised and are proposed for further development. These methodological considerations and developments will be further refined and tested and should prove useful tools for those who need to compare injury incidence data across countries.     

The institutional environment for multinational investment

This article posits that the effect of political hazards onthe choice of market entry mode varies across multinationalfirms based on the extent to which they face expropriation hazardsfrom their potential joint-venture partners in the host country(the level of contractual hazards). As political hazards increase,the multinational faces an increasing threat of opportunisticexpropriation by the government. Partnering with host-countryfirms that possess a comparative advantage in interactions withthe host-country government can safeguard against this hazard.However, as contractual hazards increase, the potential benefitto the joint-venture partner of manipulating the political systemfor it's own benefit at the expense of the multinational increasesas well, thereby diminishing the hazard-mitigating benefit offorming a joint venture. A two-stage bivariate probit estimationtechnique is used to test these hypotheses on a sample of 3,389overseas manufacturing operations by 461 firms in 112 countries.     

Developing a glossary of terms for burden of injury studies

Objectives. To compile and publish a dictionary of terminology containing a set of terms representing concepts found in burden of injury studies. Methods. A systematic outline of the glossary was designed on the basis of the literature. The glossary was filled with concepts and terms brought up by experts in the field of burden of injury research. Decisions were made by experts from several European countries in the field of burden of injury research. Definitions are based on the international literature, existing glossaries, medical dictionaries and expert opinion. In group sessions, the experts decided on preferred terms/definitions, admitted terms/definitions, and refused terms/definitions. Results. The glossary consists of three parts: concepts in health economics, concepts in health status measurement and valuation, and concepts related to health care practice. The glossary contains about 140 terms and is publicly available via the Internet. Conclusions. The glossary fulfils a clear need for uniform terminology. New terms will be considered and assessed by a group of experts. In order to make the glossary more user-friendly, interactive software should be developed.     

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).