Use of injury surveillance data in prevention work a cooperation by Gothenburg region s local communities

Transcription

1 Use of injury surveillance data in prevention work a cooperation by Gothenburg region s local communities Robert Ekman, Associate Professor Jan Schyllander, Investigator Anders Jonsson, Statistician Swedish Civil Contingencies Agency (MSB) & Gotheburg City and GR SafeCommFalköping4-5June2012

2 Place for action Sweden Population 9, 4 million Counties 21 Municipalities 290 Area km2 Western Sweden GR 13 Municipalities inhabitants

3 Information on the study area Ale Alingsås Göteborg Härryda Kungsbacka Kungälv Lerum Lilla Edet Mölndal Partille Stenungsund Tjörn Öckerö Gothenburg Region (GR) has residents Gothenburg City has over residents

4 Purpose of study The local governments in GR worked with the Swedish Civil Contingencies Agency (MSB in Swedish), beginning in 2009, to develop a joint injury surveillance system. The objectives are: To compile local injury data from, hospitalisations, and injury deaths into an Injury Atlas. To list and describe local and regional injury data collection systems and sources. To establish national support contacts, including the MSB, the National Board of Health and Welfare, and others. To evaluate the need for better coordination of, and support for, local injury surveillance systems in the GR region, and To develop a list of actions needed to use the findings from this new system to develop comprehensive injury prevention actions.

5 Organisation Support from the 13 city and county government administrators in GR in the Western Sweden Organisation support established in 2009, from both MSB and GR Steering Committee Project specialists Reference group: Network composed of local injury prevention officers/safety officers

6 Findings so far As a result of unintentional and intentional injuries in avarage per year inside GR: 400 injury deaths between people required hospitalisation between injury-related outpatient visits to E.D year old at daycare Fell down stairs Emergency care for head injury Description from patient records

7 Summary of findings, continued Injury-related costs for national, county, municipal, employers, organisations, households and individuals (social costs) are estimated to be 59 Billion Swedish crowns,( ) using 2005 prices, or around US dollars (2006 rates) for Sweden as a whole. GR region-estimates for injury-related costs are 6.1 billion Swedish crowns, of which 3.4 billion crowns are results of injuries in Gothenburg city. Each day, injuries cost the GR region about 17 million crowns (about 2.5 million US) of which 9 million crowns are due to injuries occuring within Gothenburg city. These estimates exclude costs related to intentional injuries, either caused by the individual, or others, including criminal acts.

8 Question Are all these costs just a necessary expense that we ll have to pay in the coming decades, or should we try to collaborate to reduce injuries, and suffering?

9 Injury prevention is an effective investment Injuries cost GR region about 17 million crowns a day. The costs of a injury registration system in the GR region is estimated at about million crowns a year. If an injury surveillance system could help reduce injuries by a minimum of.25% (one fourth of one percent), then the costs of the surveillance system could be recovered. An injury reduction of only 1% could save GR region about 43 million crowns (about 6.6 million dollars) a year. Estimates derived from A Tennlind, Swedish Board of Health and Welfare, computed by R Ekman and J Schyllander, MSB

10 Injury events mortality and hospitalization - by sector Traffic 10% Trafik 10% Arbete 10% Work 10% Home Hem and & fritid Leisure 80%

11 Trends - Injury categories are increasing and decreasing Increasing Falls Poisonings Decreasing Traffic Work

12 Important questions for our project In which environments are injuries occuring? Which groups of people are most vulnerable to injuries? Which injuries occur most often? What are the most effective prevention measures we can use?

13 Acute injury-related visits by location Injury location, in GR per year Estimated total Percent of total Transportation Home Production and manufacturing Shopping, consumer activities Schools and public areas Sports and recreation Amusement, cultural activities, parks Free nature- natural environment Rivers, lakes, oceans Other, unspecified Extrapolated from the National Injury Data Base

14 Some injury data for the city, annually estimated acute care cases. Between people require visits to health clinics. The city s injury policy is managed by Försäkringsbolaget Göta Lejon. According to various sources: Betwwen 1500 to 1800 insurance claims for injuries occurring for people 0 19 year olds every year In 2008, 1108 children ages 0-17 were hospitalised due to injuries- this is about 9% of all childrens hospitalisations. This data indicates that about children require acute care each year. 23 year old female. Took pills in suicide attempt Was found and taken to acute care. Recorded as poisoning due to medication Overdose and hospitalised. From patient journal.

15 More injury surveillance findings for the city A total of 1741 employees and self-employed people were registered with work-related injuries in various workplaces in Hypothesis: Would an injury registration system in the city show work-related injuries each year?

16 Focus on vulnerable groups Barn/unga Children Youth Older people

17 Injury mortality per year per 1000 residents males Examples Injury mortality per year per 1000 residents females

18 Averages, injury-related mortality per residents, by municipality-city area, , compared with Öckerö Lundby Örgryte-Härlanda Lilla Edet Majorna-Linné Alingsås Centrum Övriga Västra Götaland Östra Göteborg Göteborg Norra Hisingen Sverige Övriga Sverige Askim-Frölunda-Högsbo Ale Stenungsund GR-kommunerna Tjörn Kungälv Lerum Västra Hisingen Mölndal Angered Partille Härryda Västra Göteborg Kungsbacka 0 0,05 0,1 0,15 0,2 0,25 0,3 0,35 0,4 0,45 0,

19 Database : IDA-Gothenburg Region The Atlas Managed by MSB Primary users are employed in community safety and public health programmes in GR region

20 Thoughts on other applications in the future Use of existing data should be more widely spread, for example, by Räddningsinsatser/Rescue operations. More complete information on injuries in GR region. Hospital based injury registration systems are currently found in Umeå, i Skaraborg, Värmland och Uppsala (included in the Swedish Board of Health and Welfare s Injury Database, IDB Sweden). Hospitals from larger cities are not included. Why not include GR region/gothenburg? STRADA information system on traffic injuries (Swedish Transport Agency). We strongly recommend the use of SKADA at hospitals in Western Sweden, including GR region.

21 The way forward for comprehensive injury prevention Suggestions on how prevention efforts should be organised on the GR region/city-level. Management system. Document the current situation: who is doing what, which cooperations are in place. Develop a committee, with participation by political leaders, for continuous followups and evaluation. Implement SKADA injury surveillance system. Support research, and include education on injury epidemiology and prevention work at the university level, and other continuing education. Support GR region and city areas with local statistics.

22 Research and practice Injury prevention work is rewarding! We can acheive remarkable results, after only a few years. Humanitarian, and compassionate. Economically effective. Relatively easy work, and work that the community understands. But needs to be puched!

23 Thank You!