Health Economic Aspects of Injury Prevention at the Municipal Level

Abstract: Unintentional injuries are a global health problem, which in 1996 was estimated to cause up to 3 million deaths per year. In Sweden, about 4,600 people die annually due to external causes of morbidity and mortality (injuries and poisoning). Among children 1 to 17 years old, injuries are the leading cause of death in Sweden for both boys and girls. Injuries are also the leading cause of life years lost before age 65 in men and the second most common in women.Injury prevention interventions and programs can be implemented to mitigate the magnitude of this public health problem, the number of injuries in society, and the substantial costs associated with injuries. Society's resources are however limited and therefore it is pivotal that interventions are cost-effective and not only effective: that is, that they provide good value for money.Hence, the aim of this thesis was to develop new knowledge and improve decision making by elaborating on some of the important health economic aspects of injury prevention. Consequently, a critical appraisal of the existing cost-effectiveness studies on injury prevention interventions and estimations of the societal costs for different types of injuries that needed medical attention were conducted. The critical appraisal of studies was limited to those studies that investigated interventions that could be implemented by municipalities. The results shows that injuries are associated with substantial societal costs but differ considerably between different types of injuries. The average cost per injury was estimated at € 2,726 and varied between € 892 and € 15,537. Furthermore, the results indicate that there are injury prevention interventions that offer good use of societal resources. However, there is  a general lack of economic evidence surrounding injury prevention interventions.This thesis has expanded the knowledge in some important health economic aspects of injury prevention. The generated knowledge may advantageously be used in future research, including cost-effectiveness analyses of injury prevention interventions, and assist in the targeting of new research. Future research should focus on estimating the cost-effectiveness of different interventions and the reductions in quality of life due to different injuries. Costeffectiveness data help decision-makers make judiciously resource allocation decisions that maximise health gain given limited budgets.