Objectives: Injuries to the hand and wrist from sport and exercise are common and costly. This cost-ofillness analysis was performed to estimate the economic implications of hand and wrist injuries that were sustained as a result of participation during sport or exercise. Perspective: Cost estimates were calculated from resource use in the emergency, inpatient and outpatient settings from the perspective of one public healthcare service. Setting: Alfred Health, a large public health service with two emergency departments located in Victoria, Australia. Methods: This descriptive epidemiological study used ICD-10 diagnostic codes and electronic billing records to identify 778 potential cases for inclusion. Electronic medical records were screened and reviewed to extract demographic and patient care journey data. Results: 692 individuals, (n = 761 individual zone of injuries), were included. Australian Rules Football (ARF) was the largest contributor to injuries (20.2%) followed by riding bicycles (15.9%. The total cost of all injuries was $790,325, with a median cost per case of $278 [IQR $210–$۲۸۲] in the Emergency Department n = 692, $3328 [IQR $2242–$۶۴۴۱] in the inpatient setting n = 76 and $630 [IQR $460–$۸۷۰] in the outpatient setting n = 244. Conclusions: Hand and wristinjuries sustained from sport and exercise contribute to a significant financial burden on the healthcare system. Future research that considers the costs that occur outside of the public healthcare service is required estimate the burden associated with these injuries comprehensively. Injury prevention programs may mitigate the observed injury trends.

Introduction

Sport is one of the defining cultural pastimes and interests in Australia. The broader benefits of sport are increasingly acknowledged by governments, businesses and communities1,2 with estimates of participation rates within the Australian population varying from 28 to 40% for organised physical activity and 60–۷۰% for non-organised physical activity.3 Sport is an effective means for combating the rising rates of obesity and chronic illness, crime rates, as well as improving levels of physical and mental health.4,5 Despite these health and social benefits, organised and non-organised sport or exercise also has the potentialto cause serious injury at a significant cost to both the individual, their family and broader society. In Australia, itis estimated that annually one in seventeen sportplaying individuals sustain an injury that is significant enough to miss a game or training, leave the field of play, or seek medical or first aid treatment.7 In 2011-12 approximately 36,000 people aged 15 years and older were hospitalised as the result of an injury while playing sport and spent a total of 79,000 days in hospital.6 In addition to the impact on the individual (i.e. pain, discomfort, physical impairment, loss of productivity), sports injuries place a heavy burden on Australian society with costs upwards of $2 billion dollars each year.8 While injuries to the shoulder and knee receive much attention, approximately 25% of sports injuries involve the hand or wrist.9 Furthermore, 20% of sports-related fractures are sustained in the hand or wrist, second only to the knee/lower leg (23%).6 In Australia, no published evidence currently exists that examines the epidemiology, costs, and medical care resource consumption for sports-related acute hand and wrist injuries due to the absence of a national systematic patient data repository. Accurate information regarding costs and resources used in the provision of healthcare is essential to policymakers, funders and health service managers for planning and resource distribution.