Community-based injury prevention: effects on health care utilization

Background Worldwide, an estimated 78 million people are disabled each year because of unintentional injuries and about 3 million die. The WHO Safe Co mmunity model is a framework for community-based injury prevention programm es. The aim of this study is to evaluate the outcome on health care utiliza tion of a Safe Community programme. Methods The incidence of injuries treated at health care facilities in an i ntervention municipality (pop. 41 000) was compared to the injury incidence in a control municipality (pop. 26 000). The incidence was recorded immedi ately before and one year after programme implementation from registrations made during all first-contact health care visits and from examination of h ospital discharge registers. Results The incidence of health care treated injuries in the intervention a rea had decreased by 13% (95% CI : 9-16%) from 119 (95% CI : 115-122) per 1 000 population-years to 104 (95% CI : 101-107). In the control area, the co rresponding 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 car e 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 s how significant change. Conclusion This first controlled evaluation showed that an injury preventio n programme based on local action groups can significantly reduce injuries requiring health care in a community. Local prevention can provide a comple ment to national level campaigns.