A booming economy means a bursting trauma system: association between hospital admission for major injury and indicators of economic activity in a large Canadian health region

Derek J Roberts; Debanjana Das; Michelle Mercado; Christine Vis; John B Kortbeek; Andrew W Kirkpatrick; Chad G Ball

doi:10.1016/j.amjsurg.2013.12.011

A booming economy means a bursting trauma system: association between hospital admission for major injury and indicators of economic activity in a large Canadian health region

Am J Surg. 2014 May;207(5):653-7; discussion 657-8. doi: 10.1016/j.amjsurg.2013.12.011. Epub 2014 Jan 31.

Authors

Derek J Roberts¹, Debanjana Das², Michelle Mercado³, Christine Vis³, John B Kortbeek⁴, Andrew W Kirkpatrick⁵, Chad G Ball⁶

Affiliations

¹ Department of Surgery, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada; Department of Community Health Sciences, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada.
² Department of Surgery, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada.
³ Department of Regional Trauma Services, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada.
⁴ Department of Surgery, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada; Department of Regional Trauma Services, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada; Department of Critical Care Medicine, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada.
⁵ Department of Surgery, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada; Department of Regional Trauma Services, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada.
⁶ Department of Surgery, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada; Department of Regional Trauma Services, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada; Department of Oncology, University of Calgary, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, AB T2N 2T9, Canada. Electronic address: [email protected].

PMID: 24560360
DOI: 10.1016/j.amjsurg.2013.12.011

Abstract

Background: Injury epidemiology fluctuates with economic activity in many countries. These relationships remain unclear in Canada.

Methods: The annual risk of admission for major injury (Injury Severity Score ≥12) to a high-volume, level-1 Canadian trauma center was compared with indicators of economic activity over a 16-year period using linear regression.

Results: An increased risk of injured patient admissions was associated with rising mean gross domestic product (GDP [millions of chained 2002 dollars]) (.36 person increase per 100,000 population/$1,000 increase in GDP; P = .001) and annual gasoline prices (.47 person increase per 100,000 population/cent increase in gasoline price; P = .001). Recreation-related vehicle injuries were also associated with economic affluence. The risk of trauma patient mortality with increasing mean annual GDP (P = .72) and gasoline prices (P = .32) remained unchanged.

Conclusion: Hospital admissions for major injury, but not trauma patient mortality, were associated with economic activity in a large Canadian health care region.

Keywords: Ecological study; Economic indicators; Major trauma; Wounds and injuries.

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Alberta / epidemiology
Economics / statistics & numerical data*
Female
Gross Domestic Product / statistics & numerical data
Hospitalization / statistics & numerical data*
Hospitals, High-Volume / statistics & numerical data
Humans
Injury Severity Score
Linear Models
Male
Middle Aged
Registries
Trauma Centers / statistics & numerical data*
Wounds and Injuries / economics*
Wounds and Injuries / epidemiology
Young Adult