Objectives: To determine the demands on healthcare resources caused by different types of illnesses and variation with age and sex.

Recovery patterns vary widely between nonhospitalized, shortly, and long hospitalized injury patients. Nonhospitalized injury patients recover within 5 months from an injury whereas a considerable group of hospitalized injury patients suffer from persistent health problems. Our study indicates the importance of health monitoring with an adapted longitudinal design for injury patients. The time intervals used should match the various stages of the recovery process, which depends on the severity of the injury studied.

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Our guidelines should be tested and may lead to improved and more consistent epidemiologic data on the incidence, severity, and duration of injury-related disability.

Our results suggest that the economic costs of socioeconomic inequalities in health in Europe are substantial. As this is a first attempt at quantifying the economic implications of health inequalities, the estimates are surrounded by considerable uncertainty and further research is needed to reduce this. If our results are confirmed in further studies, the economic implications of health inequalities warrant significant investments in policies and interventions to reduce them.

Injury is a major source of disease burden and work absence. Both hospitalized and nonhospitalized patients contribute significantly to this burden.

Objective To assess injury-related mortality, disability and disability-adjusted life years (DALYs) in six European countries. Methods Epidemiological data (hospital discharge registers, emergency department registers, mortality databases) were obtained for Austria, Denmark, Ireland, Netherlands, Norway, and the United Kingdom (England and Wales). For each country, the burden of injury was estimated in years lost due to premature mortality (YLL), years lived with disability (YLD), and DALYs (per 1000 persons). Findings We observed marked differences in the burden of injury between countries. Austria lost the largest number of DALYs (25 per 1000 persons), followed by Denmark, Norway and Ireland (17-20 per 1000 persons). In the Netherlands and United Kingdom, the total burden due to injuries was relatively low (12 per 1000 persons). The variation between countries was attributable to a high variation in premature mortality (YLL varied from 9-17 per 1000 persons) and disability (YLD varied from 2-8 per 1000 persons). In all countries, males aged 25-44 years represented one third of the total injury burden, mainly due to traffic and intentional injuries. Spinal cord injury and skull-brain injury resulted in the highest burden due to permanent disability. Conclusion The burden of injury varies considerably among the six participating European countries, but males aged 15-24 years are responsible for a disproportionate share of the assessed burden of injury in all countries. Consistent injury control policy is supported by high-quality summary measures of population health. There is an urgent need for standardized data on the incidence and functional consequences of injury.Bulletin of the World Health Organization 2007;85:27-34.Voir page 33 le résumé en français. En la página 33 figura un resumen en español. Assessing the burden of injury in six European countries IntroductionInjuries are a major cause of morbidi i ity and mortality in developing and in industrialized regions.1,2 Rational choices for injury prevention need to rely on comparable indicators relating the burden of injury to other diseases, and determining the most prevailing and incapacitating types of injury. Summary measures of population health, such as the disabilityiadjusted life year (DALY) are designed for the comparative analysis of burden. 3 The value of the DALY as a tool for health policy and planning puri i poses has been increasingly recognized. 4 The DALY combines information on premature mortality and disability due to nonifatal health outcomes. It is a soicalled 'health gap measure' of which the quantitations can be interpreted as the gap between the current population health status and an ideal situation in which everyone would live into old age free of disease and disability. 5 The DALY was designed to assess the burden of disease beyond mortality and was aimed for national and international health policies, to develop unbiased epidemioi i logical assessments for major disorders, and to provide an outcome measure that could also be use...

Elderly patients aged 65 years and older, especially women, consume a disproportionate share of hospital resources for trauma care, mainly caused by hip fractures and fractures of the knee/lower leg, which indicates the importance of prevention and investing in trauma care for this specific patient group.