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Monetised estimated quality-adjusted life year (QALY) losses for non-fatal injuries
  1. Gabrielle F Miller1,
  2. Curtis Florence1,
  3. Sarah Beth Barnett1,
  4. Cora Peterson1,
  5. Bruce A Lawrence2,
  6. Ted R Miller2
  1. 1 National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  2. 2 Pacific Institute for Research and Evaluation, Calverton, Maryland, USA
  1. Correspondence to Dr Gabrielle F Miller, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; ygm3{at}


Background Quality-adjusted life years (QALYs) provide a means to compare injuries using a common measurement which allows quality of life and duration of life from an injury to be considered. A more comprehensive picture of the economic losses associated with injuries can be found when QALY estimates are combined with medical and work loss costs. This study provides estimates of QALY loss.

Methods QALY loss estimates were assigned to records in the 2018 National Electronic Injury Surveillance System - All Injury Program. QALY estimates by body region and nature of injury were assigned using a combination of previous research methods. Injuries were rated on six dimensions, which identify a set of discrete qualitative impairments. Additionally, a seventh dimension, work-related disability, was included. QALY loss estimates were produced by intent and mechanism, for all emergency department-treated cases, by two disposition groups.

Results Lifetime QALY losses ranged from 0.0004 to 0.388 for treated and released injuries, and from 0.031 to 3.905 for hospitalised injuries. The 1-year monetary value of QALY losses ranged from $136 to $437 000 among both treated and released and hospitalised injuries. The lifetime monetary value of QALY losses for hospitalised injuries ranged from $16 000 to $2.1 million.

Conclusions These estimates provide information to improve knowledge about the comprehensive economic burden of injuries; direct cost elements that can be measured through financial transactions do not capture the full cost of an injury. Comprehensive assessment of the long-term cost of injuries, including quality of life losses, is critical to accurately estimate the economic burden of injuries.

  • quality of life
  • costs
  • multiple injury

Data availability statement

Data are available upon reasonable request. Data may available through relevant data sharing requests.

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Data availability statement

Data are available upon reasonable request. Data may available through relevant data sharing requests.

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  • Contributors GM conceptualised the study, drafted the manuscript and reviewed the final manuscript. CF conceptualised the study and revised/reviewed the final manuscript. SBB and CP drafted the manuscript and reviewed the final manuscript. BL and TRM conceptualised the study, conducted the analysis and reviewed the final manuscript. All authors edited the manuscript and approved the final manuscript as submitted.

  • Funding This work was partially funded by a contract with the CDC (75D30118P01557).

  • Disclaimer The findings and conclusions in this manuscript are those of the authors and do not necessarily represent the official position of the CDC.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.