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Are cost of injury studies useful?
  1. Gillian Currie1,
  2. Karin Dymond Kerfoot2,
  3. Cam Donaldson1,
  4. Colin Macarthur3
  1. 1University of Calgary, Calgary, Alberta, Canada: Departments of Economics and Community Health Sciences
  2. 2Department of Community Health Sciences
  3. 3Departments of Community Health Sciences and Paediatrics
  1. Correspondence to:
 Dr Colin Macarthur, Department of Community Health Sciences, Health Sciences Center, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1
 (email: colinmac{at}

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Studies from the USA and Canada have attempted to estimate the economic costs associated with injury.1–3 The rationale for these studies is often to provide data for priority setting (both research and policy). In other words, the expression of the cost of injury in monetary terms is thought to illustrate the importance of the problem and, therefore, its high priority for research and health services resources. For example, some authors have suggested that policy makers identify “high cost” injuries (compared with other injuries) and make these injuries a priority for treatment and prevention programs.1,3

Cost of injury studies may be useful in the “political” sense, for example, by raising public and political awareness of the burden of injury. Our argument, however, is that such studies are not helpful in the context of setting priorities for resource allocation and research activities. Furthermore, concentration on cost of injury studies may divert policy makers from what they need to know in order to maximise societal benefits from resource allocation. In this paper, we briefly describe the cost of injury method, explain why cost of injury studies have limited usefulness, and explain how, in our view, health economics can better contribute to the field of injury prevention.

Cost of injury method

Cost of injury studies usually include both direct and indirect costs. Direct costs are those resources used to prevent, detect, and treat injury and its complications. The resource use in each of these categories is measured, valued, and summed. The most common method involves combining data on health care utilisation and costs; for example, the length of hospital stay for a specific injury is multiplied by an estimate of the cost per day for that injury. Indirect costs relate to the loss of productive output in the economy because of …

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