International Journal of Epidemiology, Vol 28, 502-508, Copyright © 1999 by International Epidemiological Association
T Timpka, K Lindqvist, L Schelp and M Ahlgren
BACKGROUND: Worldwide, an estimated 78 million people are disabled each
year because of unintentional injuries and about 3 million die. The WHO
Safe Community model is a framework for community-based injury prevention
programmes. The aim of this study is to evaluate the outcome on health care
utilization of a Safe Community programme. METHODS: The incidence of
injuries treated at health care facilities in an intervention municipality
(pop. 41,000) was compared to the injury incidence in a control
municipality (pop. 26,000). The incidence was recorded immediately before
and one year after programme implementation from registrations made during
all first-contact health care visits and from examination of hospital
discharge registers. RESULTS: The incidence of health care treated injuries
in the intervention area had decreased by 13% (95% CI: 9-16%) from 119 (95%
CI: 115-122) per 1000 population-years to 104 (95% CI: 101-107). In the
control area, the corresponding injury incidences were 104 (95% CI:
100-108) and 106 (95% CI: 102-109). The hospital-treated injuries in the
intervention area decreased by 15% (95% CI: 7-24%) from 19 (95% CI: 17-20)
per 1000 population-years to 16 (95% CI: 15-17), while in the control area,
the incidences remained at 13 (95% CI: 11-14) per 1000 population-years.
Utilization of acute care in the intervention area for reasons other than
injuries increased by 8% (95% CI: 6-10%), while in the control area, the
number of visits did not show significant change. CONCLUSION: This first
controlled evaluation showed that an injury prevention programme based on
local action groups can significantly reduce injuries requiring health care
in a community. Local prevention can provide a complement to national level
campaigns.
ARTICLES
Community-based injury prevention: effects on health care utilization
Department of Social Medicine and Public Health Science, Linkoping University, Sweden.
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