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Cost of injuries from a prospective cohort study of North Carolina high school athletes

¹ Department of Epidemiology, School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
² The University of North Carolina Injury Prevention Research Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
³ Department of Orthopedics, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
⁴ Pacific Institute for Research and Evaluation, Calverton, MD, USA
⁵ Department of Health Behavior and Health Education, School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
⁶ Department of Community and Behavioral Health, College of Public Health, The University of Iowa, Iowa City, IA, USA
⁷ Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

Correspondence to:
Dr S B Knowles, Palo Alto Medical Foundation Research Institute, Department of Health Services Research, 795 El Camino Real, Ames Building, Palo Alto, CA 94301, USA; knowless{at}pamfri.org

Objective: To estimate the economic cost of injuries in a population of US high school varsity athletes.

Design and Setting: The North Carolina High School Athletic Injury Study, conducted from 1996 to 1999, was a prospective cohort study of injury incidence and severity. A two-stage cluster sampling technique was used to select athletic teams from 100 high schools in North Carolina. An injury cost model was used to estimate the economic cost of injury.

Participants: Varsity athletes from 12 sports: football, girls’ and boy’s soccer, girls’ and boys’ track, girls’ and boy’s basketball, baseball, softball, wrestling, volleyball, and cheerleading.

Main outcome measures: Descriptive data were collected at the time of injury. Three types of costs were estimated: medical, human capital (medical costs plus loss of future earnings), and comprehensive (human capital costs plus lost quality of life).

Results: The annual statewide estimates were $9.9 million in medical costs, $44.7 million in human capital costs, and $144.6 million in comprehensive costs. The mean medical cost was $709 per injury (95% CI $542 to $927), $2223 per injury (95% CI $1709 to $2893) in human capital costs, and $10 432 per injury (95% CI $8062 to $13 449) in comprehensive costs. Sport and competition division were significant predictors of injury costs.

Conclusions: Injuries among high school athletes represent a significant economic cost to society. Further research should estimate costs in additional populations to begin to develop cost-effective sports injury prevention programs.

Abbreviations: BMI, body mass index; coach EQT, coaching experience, qualifications, and training; ED, emergency department; NCHSAIS, North Carolina High School Athletic Injury Study; QALY, quality-adjusted life year; RICM, Revised Injury Cost Model

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