Background Malaysia is rapidly developing and facing an increase in the burden of injuries, which disproportionally affect young and economically productive individuals. This study aims to understand injury-related economic burden on individuals and their families over time.

Methods We are recruiting a prospective cohort of 1200 moderately to severely injured patients from two government hospitals in Selangor and Kedah, Malaysia. We administer a baseline and four follow-up surveys (1, 2, 4, 12 months after discharge) to subjects about socio-demographic characteristics, injury, family structure, and income changes. We obtain medical costs (direct costs) from medical bills and expenditure diaries. The outcome measures are direct and indirect costs.

Results Of 284 participants enrolled, 75% are male and 82% are Malay. Road traffic injury (70%), fall (17%) and blunt object injury (17%) are the top three causes of injuries. On average, participants were hospitalised for 9.7 days (SD: 11.8), which was associated with productivity losses equivalent to RM411 (SD: 600) per person. Before injury, the average monthly income of participants was RM1304 (SD: 940), and the average medical care costs were RM156 (SD: 152). Income during hospitalisation was reduced in 24% of participants (RM534 on average). We will use marginal models with Generalised Estimating Equations to examine the trend of average costs. We will estimate average income changes by modelling the likelihood of having income reduction using logistic regression and size of income reduction using generalised linear regression.

Conclusions Injury brings about significant financial stress to individuals through direct medical costs, productivity loss and income reduction. This study will provide empirical evidence on the trend of injury costs and identify factors associated with high injury costs in Malaysia.