Parachute Canada Excerpts

“The Cost of Injury in Canada: The clock is ticking” Parachute. (2015).

P.158: In cases where treatment was initiated in an emergency department, with a subsequent hospital admission, the case would be included in both non-hospitalized and hospitalized categories in order to capture treatment costs in both settings.

P.157: An extensive search of the literature revealed a major study in the United States. Miller’s Databook on Nonfatal Injury: Incidence, Costs and Consequences proved to be instrumental in helping to fill the large gaps by providing missing data and coefficients. This groundbreaking work allowed for a more complete estimate of the economic cost of unintentional injury in Canada by providing a mechanism to calculate:

❖ Direct morbidity costs for out-of-hospital treatment related to injuries, using ratios of episodes and related costs of non-hospitalized to hospitalized cases from the United States; and

❖ Incidence of both permanent partial and total disability using coefficients that relate these episodes and related costs (both direct and indirect) to the incidence of hospitalized and non-hospitalized cases from the United States.

P.159: Medical and rehabilitation costs were calculated using provincial hospital costs, in conjunction with the distribution of ICD-10 N-codes by ICD-10 external cause of injury codes derived from CIHI hospital data, and coefficients derived from Tables 5.6 and 5.9 of Miller's Databook.

Disability

P. 159: Permanent partial and permanent total disability from injury were estimated using both hospitalized and non-hospitalized injury in conjunction with the distribution of ICD-10 N-codes by ICD-10 external cause of injury codes derived from CIHI hospital data, and coefficients derived from Tables 4.12 and 4.15 of Miller's Databook.

Long-term medical costs were calculated using hospital costs in conjunction with coefficients derived from Tables 3.1 and 3.2 of the Databook, while the indirect cost associated with income loss was assumed to be 100% for total permanent disability, and 17% for partial permanent disability.

Population denominators Estimates of populations by age, gender, and province for 2010 were obtained from Statistics Canada.

Caveats and data limitations p. 159: Provincial hospitalization data has been classified using the 10th Edition (ICD-10 CA) since 2002/03, while provincial mortality data has been so classified since 2000. However, the coefficients presented in Miller’s Databook on Nonfatal Injury: Incidence, Costs and Consequences are based upon injury data classified using International Classification of Disease, 9th Edition (ICD-9) groupings. As a result, the tables used from this publication required translation to ICD-10 code groupings. This was not a major task, but did involve a few minor judgment calls.

The coefficients derived from Miller’s Databook are based upon non-fatal injuries in the United States in the mid-1990s. This report assumes that these coefficients are similar to those that would be obtained from a Canadian study.

P.160: Costs will also vary according to the degree of disability and, hence, the disability coefficients from the United States related to two disability categories (partial or total) were applied to the Canadian population. Again, it was assumed that the American and Canadian situations were comparable.

P.161: The good news is that the vast majority of the injuries described in this Report are both predictable and preventable. We know when they happen and under what conditions. We know who is at risk and who is not, and we increasingly know what works and what does not with respect to prevention.

From google: who Miller is