The first detailed study on the cost of injury within Australia has been carried out by researchers at the Monash University Accident Research Centre. The study, supported by the Department of Health, was made for the State of Victoria and was directed at broadly describing the epidemiology of injury at all levels of severity and to provide an estimate of the total lifetime cost of injury to the Victorian community for injury cases occurring in 1993/94.

Broadly, the implication of the research is that the cost of injury to the state was equivalent to about half the state health budget.

While methodological choices have some impact on the results and the detail available is constrained by the level at which the analysis was carried out, nevertheless the report has interest for those with a specific interest in child injury.

For children under 5 years the direct cost of treatment was found to constitute 60% of the lifetime cost of injury, the morbidity cost 30%, and the mortality cost 11% while for children aged 5 to 14 years they were 46%, 45%, and 10%.

While the direct cost per injured child is about 20% higher less for children 5 to 14 years than for those aged under 5, the morbidity and mortality costs are substantially higher (55% and 75%). Because the differentials in cost are significant, especially in relation to death, they outweigh the fact that the rate of injury is higher for the younger age group and the total cost of injury for the older age group is double that for the younger ($160m compared with $77m).

There is also a gender difference in costs. Girls have a slightly higher average cost of death (10%) than boys, the average morbidity costs are broadly similar, and boys have a slightly higher average costs of direct treatment than girls. The slightly higher average cost of treating boys for injury combined with a substantially higher rate of injury result in the total cost of injury for boys being 40% above that for girls in children under 5 and 66% higher in children aged 5 to 14 years.

For specific causes of injury and death the top five most costly among children under 5 were: falls ($22m); poisoning ($12m); fire, flames, and burns ($8m); hit, struck, or crush injury ($7m); and motor vehicle traffic ($4m). For children aged 5 to 14 years the top five most costly causes of injury and death were: falls ($66m); hit, struck, crushed ($18m); motor vehicle traffic ($18m); other transport ($17m); and cutting, piercing injury ($8m).

The discussion on the implications of the distribution of costs, particularly in priorities for prevention and the detailed tables concerning the incidence and pattern of injury and of costs are likely to be of wide interest.

The Cost of Injury to Victoria by Wendy Watson and Joan Ozanne-Smith, Report No 124, Monash University Accident Research Centre, Wellington Road Clayton, Victoria 3168, Australia (fax: +61 3 9905 4363).