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A 10-year review of child injury hospitalisations, health outcomes and treatment costs in Australia
  1. Rebecca J Mitchell1,
  2. Kate Curtis2,
  3. Kim Foster2,3
  1. 1 Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
  2. 2 Sydney Nursing School, The University of Sydney, Sydney, New South Wales, Australia
  3. 3 Australian Catholic University & Northwestern Mental Health, Melbourne, Victoria, Australia
  1. Correspondence to Dr Rebecca J Mitchell, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW 2052, Australia; r.mitchell{at}mq.edu.au

Abstract

Background Childhood injury is a leading cause of hospitalisation, yet there has been no comprehensive examination of child injury and survival over time in Australia. To examine the characteristics, temporal trend and survival for children who were hospitalised as a result of injury in Australia.

Method A retrospective examination of linked hospitalisation and mortality data for injured children aged 16 years or less during 1 July 2001 to 30 June 2012. Negative binomial regression examined change in injury hospitalisation trends. Cox proportional hazard regression examined the association of risk factors on 30-day survival.

Results There were 6 86 409 injury hospitalisations, with an age-standardised rate of 1489 per 1 00 000 population (95% CI 1485.3 to 1492.4) in Australia. Child injury hospitalisation rates did not change over the 10-year period. For every severely injured child, there are at least 13 children hospitalised with minor or moderate injuries. The total cost of child injury hospitalisations was $A2.1 billion (annually $A212 million). Falls (38.4%) were the most common injury mechanism. Factors associated with a higher risk of 30-day mortality were: child was aged ≤10 years, higher injury severity, head injury, injured in a transport incident or following drowning and submersion or other threats to breathing, during self-harm and usual residence was regional/remote Australia.

Conclusions Childhood injury hospitalisation rates have not reduced in 10 years. Children’s patterns of injury change with age, and priorities for injury prevention alter according to developmental stages. The development of a national multisectorial childhood injury monitoring and prevention strategy in Australia is long overdue.

  • injury
  • children
  • hospitalisation
  • cost
  • mortality

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Footnotes

  • Contributors RM, KC and KF were all involved in study concept and design. RM acquired the data, conducted the analysis and wrote the first draft of the manuscript. RM, KC and KF were all involved in interpretation of data and critical revision of the manuscript.

  • Funding This research was funded by the Day of Difference Foundation.

  • Competing interests None declared.

  • Ethics approval Ethical approval was obtained from eight jurisdiction-based health ethics committees and the Australian Institute of Health and Welfare.

  • Provenance and peer review Health Department representatives in each jurisdiction and the Australian Institute of Health and Welfare had an opportunity to review the manuscript.

  • Data sharing statement The data that support the findings of this study are available from the State Health Departments and the National Death Index in Australia, but restrictions apply to the availability of these data, which were used under licence for the current study, and so are not publicly available.

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