The study, by the Trauma Audit Research Network (TARN) at The University of Manchester, looked at all penetrating trauma injuries that resulted in immediate admission to hospital for three or more days or death within 93 days.
Stabbings accounted for almost three-quarters of all penetrative injuries with an average cost to the NHS per victim of £7,196. Firearm injuries, accounting for nearly a fifth of cases studied, cost an average of £10,307 per patient, while penetrating injuries caused by vehicle collisions, only 2% of cases, cost the most at £16,185 per patient.
The research, based on TARN data from half (121) of all hospitals receiving trauma patients in England and Wales, was carried out between 1 January 2000 and 31 December 2005. The results show that there were 1,365 patients with penetrating trauma injuries, 91% of whom were male. The median age was 30 years.
More than 90% of injuries were alleged assaults, and 47% of the patients were admitted to critical care. Overall hospital mortality rate was 8.3%, and the rate for stabbing was 7%.
“Our findings indicate that the initial hospital costs associated with penetrating trauma are substantial, and vary to a considerable degree by patient, injury and treatment characteristics,” said Dr Fiona Lecky, research director at TARN.
“Although the costs of penetrating trauma resulting from shooting are higher than from stabbing, the most commonly used weapon in violent crime in England and Wales is actually a knife.
“At an average cost of £7,699 per penetrating injury from alleged assault and a total of 417 injuries per year requiring hospitalisation for at least three days, the total acute care cost of this type of injury alone may exceed £3.2 million annually.
“Public health initiatives that aim to reduce the incidence and severity of penetrating trauma are therefore likely to produce significant savings in acute trauma care costs.’’
The study, funded by TARN and Novo Nordisk and carried out by Health Economist Steven Morris from the University of Brunel, looked at treatment costs for each patient based on initial hospitalisation. It included costs of transportation, hospital stay and all surgical procedures performed.
“Considering the additional medical costs of rehabilitation and broader costs to society resulting from lost productivity, permanent disability, premature death and the pain and suffering of the victims and their families, there is a compelling argument for money to be better spent on prevention strategies that reduce violent incidents,” said Dr Lecky.
“It should be borne in mind that most of the cost of trauma, especially stabbing, is not to the health service but in billions per annum to the taxpayer through legal costs, loss of productive tax-paying years in those that die or are severely disabled and in long-term care. Trauma is the most expensive, and neglected, ‘disease’ to society because it mainly affects young tax paying people.'
The research is published online ahead of print in the journal Injury.
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