Abstract

Priority setting in healthcare, surveillance and intervention is based increasingly on burden of disease and injury studies, which integrate mortality and disability. Injury, however, challenges the underlying methodology, not in the least because of the wide range of possible consequences and recovery patterns. INTEGRIS WP5 Injury disability indicators focused on the methodology concerning the disability component (years lived with disability; YLD) of the burden of injury. This is calculated by multiplying the number of injury cases, a disability weight and average duration of the health outcome. An inventory of available methods was made by addressing key questions that are raised when assessing the disability component of injury, namely (1) which injury cases should be included?, (2) how to distinguish cases by injury diagnoses? and (3) how to link injury diagnosis to disability information concerning the disability weights and the proportion lifelong consequences? With this inventory, for each of these methodological questions WP5 provided a theoretical framework and proposed recommendations to assess the disability component of the burden of injury. Additionally, an implementation tool including a set of 87 injury disability weights and proportions of lifelong consequences for 27 injury diagnoses have been determined. In the Netherlands, the WP5 tool has been applied in national injury estimations of the National Institute of Public Health, highly increasing the burden of injury compared the previously used, hampered, methodology. This allowed Dutch policy makers to base their decisions regarding resource allocation on a more complete burden of injury estimate.