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Costs of injury in New Zealand: Accident Compensation Corporation spending, personal spending and quality-adjusted life years lost
  1. Ross Wilson1,
  2. Sarah Derrett1,
  3. Paul Hansen2,
  4. John Desmond Langley1
  1. 1Injury Prevention Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
  2. 2Department of Economics, University of Otago, Dunedin, New Zealand
  1. Correspondence to Ross Wilson, Injury Prevention Research Unit, Department of Preventive & Social Medicine, University of Otago, Dunedin 9054, New Zealand; ross.wilson{at}


Background New Zealand offers a unique opportunity for cost-of-injury research due to its comprehensive, no-fault injury compensation insurance scheme, which is managed by the government-controlled Accident Compensation Corporation (ACC).

Objectives To estimate the costs of injury in New Zealand with respect to ACC's spending for entitlement claimants (ie, people with injuries requiring more than ‘treatment only’), as well as injured individuals' out-of-pocket personal spending and non-pecuniary costs in terms of effects on health-related quality of life (HRQoL).

Methods A prospective cohort study of people injured between June 2007 and May 2009 was followed for 12 months after injury. ACC's spending for each participant (n=2215) was estimated from ACC data. Out-of-pocket personal spending and quality-adjusted life years (QALYs) lost were estimated based on interviews conducted at 3, 5 and 12 months post injury.

Results For the cohort studied, most of the reported financial costs of injury were met by ACC. ACC spending was higher for individuals with more severe injuries and ones admitted to hospital. There was no difference in mean personal spending between people who were hospitalised or not, or between those with minor or moderate injuries, although individuals with more severe injuries reported higher personal spending.

Conclusions Overall, the ACC appears to be performing well supporting injured people financially. Nonetheless, people with more severe injuries incur substantial out-of-pocket expenses. Costs are higher for hospitalised and more severe injuries, but non-hospitalised and less severe cases can still incur substantial costs. The HRQoL effects of injury—naturally, borne by injured individuals themselves—are relatively large on average.

  • Injury
  • treatment costs
  • quality-adjusted life years
  • cost

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  • SD is a member of the EuroQol Scientific Committee, which developed the EQ-5D instrument used in the study.

  • Funding This study was funded by the Health Research Council of New Zealand (2007–2013) and co-funded by the Accident Compensation Corporation, New Zealand (2007–2010). The views and conclusions in this article are the authors' own and may not reflect those of the funders.

  • Competing interests All authors declare that they have no financial interests relevant to the submitted work.

  • Patient consent Obtained.

  • Ethics approval New Zealand Health and Disability Multi-region Ethics Committee (MEC/07/07/093).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The authors are willing to share data, as appropriate.