Injury rate and socioeconomic costs resulting from sports injuries in Flanders: data derived from sports insurance statistics 2003 E Cumps, 1,2 E Verhagen, 3 L Annemans, 4 R Meeusen 1 1 Department of Human Physiology and Sports Medicine, Vrije Universiteit Brussel, Brussels, Belgium; 2 Policy Research Center Sports, Physical Activity and Health, Leuven, Belgium; 3 VU University Medical Centre, EMGO Institute, Amsterdam, The Netherlands; 4 Department of Public Health, Faculty of Medicine, University of Gent, Gent, Belgium Correspondence to: Romain Meeusen, Department of Human Physiology and Sports Medicine, Vrije Universiteit Brussel, Pleinlaan 2 B-1050, Brussels, Belgium; rmeeusen@vub.ac.be Accepted 3 November 2007 Published Online First 29 November 2007 ABSTRACT Objective: This study determines the injury rate (%) and the associated direct medical and indirect costs of sports injuries in Flanders. Setting: Epidemiological cohort designs and a human capital method were set up to measure respectively the medical direct and indirect cost of sports injuries. Participants: 72 out of 82 Flemish sports federations participated. Intervention: Insurance statistics from 2003 were used to determine the overall rate of injury and injury localisations. Using these data, the medical direct cost and the impact sports injuries have on indirect costs were estimated. The indirect costs were determined by multiplying the days of absence from work with the daily cost resulting from a loss of production, being J200. Main outcome: The total direct medical cost extra- polated for the Flemish sports participants was J15 027 423, which amounted to 0.07% to 0.08% of the total budget spent on healthcare. The indirect cost extrapolated for the Flemish sports participants was J111 420 813, which is about 3.4% of the costs arising from absenteeism from work. Results: Of the 14 in-depth analysed sports, the rate of injury was highest in European team handball (8.96%; 95% confidence interval (CI) 8.95–8.96) and lowest in swimming (0.62%; 95% CI 0.62–0.62). The highest direct medical cost was found for anterior cruciate ligament (ACL) injuries (J1358 per injury) and the lowest for foot injuries (J52 per injury). Conclusion: The costs calculated in this study could become critical statistics in medical care debates. Data obtained here will enable a cost2benefit analysis of the impact of preventive measures to be made. It is a well known fact that any sort of sports or physical activity comes with a certain risk of injury. 1 With the current sports and fitness hype and the active government promotion of an active lifestyle we can consequently also expect an increased number of sports injuries. 2 Fortunately, most are not life threatening, and it goes without saying that the health benefits of sports by far outweigh any of the risks involved. 3 Nevertheless, we cannot ignore the fact that sometimes sports injuries do cause physical disability beyond pain or other physical discomforts, which in turn results in use of healthcare resources and possibly absentee- ism from work. It is surprising how little we know about the costs involved with sports injuries. The costs of knee injuries and knee surgery as a result of sports participation have been documented and Verhagen et al (2005) have evaluated the economic benefits of a proprioceptive balance board training programme for the prevention of ankle sprains in volleyball. 4–6 Hoy and Lindblad (1992, 1994) performed an epidemiological and socioeconomic study in bad- minton, European team handball and outdoor football, and there is also some information to be found on costs of occupational injuries in the USA. 7–14 Socioeconomic evaluation aims at aiding policy makers in deciding whether or not to implement or fund new healthcare measures. 15 To ensure that the decision maker is supplied with all the relevant information, it is generally recommended to go with the societal perspective for any economic evaluations involved. 15 This means that all relevant costs and effects need to be incorporated in the analysis, regardless of who bears the costs and who experiences the effects. 15 Although injury has been recognized to be a major public health problem, data on costs are still in short supply. The lack of complete and accurate data limits the ability to focus on a variety of data- oriented aspects of injury control that potentially could reduce the incidence of sports injuries as well as healthcare costs and loss of productivity associated with them. Because of the scarcity of studies concerning the socioeconomic conse- quences of sports injuries and given their potential importance to determine health benefit costs of prevention strategies, our intention was to analyse all costs incurred within sports injuries occurring in Flanders, be it directly or indirectly. METHODS Subjects In Flanders there are 121 sports federations. 16 The term "sports federation" applies to every organisa- tion with a private law that unites, supports, informs and represents all sports clubs within one sports discipline, this in a voluntary and generous manner. 17 All sports federations that did not fit the definition of sports and were not on the list of sports disciplines as formulated by the Flemish government were excluded (n = 24). Ten of the listed Flemish sports federations were not included in the study because they were organisa- tions that supported the sports federations with- out any direct relation to sports participation. 17 18 Five Flemish sports federations were already part of one of the coordinating sports federations. A total of 82 sports federations were eligible for analysis. Original article Br J Sports Med 2008;42:767–772. doi:10.1136/bjsm.2007.037937 767 group.bmj.com on March 1, 2012 - Published by bjsm.bmj.com Downloaded from