Economic Burden of Injuries


Lead Author(s): 

Edward H Yelin, PhD
Miriam G. Cisternas, MA

Supporting Author(s): 

Sylvia I Watkins-Castillo, PhD

Between the years 1996-1998 and 2012-2014, the number of persons in the population reporting a musculoskeletal injury rose only slightly, from 23.4 million to 26.3 million, resulting in a slight decline in the proportion of the population with a musculoskeletal injury (8.6% to 8.3%). However, the distribution of the population with a musculoskeletal injury, by age group, showed a consistent shift upward as the population ages, reflecting the overall aging of the U.S. population. Persons in the 44 to 64-year age group showed the sharpest increase, but there was a jump in the 65 and over population as the Baby Boomers cohort ages. (Reference Table 8.1.5 PDF CSV)

Healthcare treatments and visits contribute to the burden of musculoskeletal injuries. Ambulatory nonphysicians are showing the fastest rise in the number of healthcare visits for musculoskeletal injuries (130%) between the years 1996-1998 to 2012-2014, from 54 million to 124 million visits, and are starting to approach physician office visits, which averaged 145 million visits per year 2012-2014. Hospital discharges for musculoskeletal injuries remain a very small proportion of overall treatment visits (< 3 million), indicating that most musculoskeletal injuries are not serious enough to require hospitalization. Prescription medications for musculoskeletal injuries more than doubled over the time frame, jumping from 201 million prescriptions to 423 million between 1996-1998 and 2012-2014, an increase of 111%.  (Reference Table 8.2.5 PDF CSV)

Direct Medical Costs

In recent years, ambulatory care visits account for the largest share of per person direct cost for persons with a musculoskeletal injury, with the share increasing while inpatient costs share drops. In 2014 dollars, the average cost per person in 2012-2014 for ambulatory care was $2,949, an increase of 109% from 1996-1998, although the share of total costs increased only 3% (33% to 36%). The share of mean per person cost for inpatient care dropped from 34% to 28% between 1996-1998 and 2012-2014,  but the mean cost in 2014 dollars rose from $1,421 to $2,283, an increase of 61%. At the same time, the average per person cost for prescriptions rose from $444 to $1,569, an increase of 253%.  (Reference Table 8.4.5 PDF CSV)

Total direct per person healthcare cost for persons with a musculoskeletal injury were $8,135, an increase of 93% since 1996-1998, in 2014 dollars. Incremental direct per person costs, those costs most likely attributable to a musculoskeletal injury, rose from $1,261 to $2,022, in 2014 dollars, an increase of 60%. Total aggregate direct costs for persons with a musculoskeletal injury were $214 billion in 2012-2014, a rise of 117% from the $98 billion in 1996-1998, in 2014 dollars. Incremental aggregate direct costs increased from $29 billion in 1996-1998 to $53 billion in 2012-2014, an increase of 80%. (Reference Table 8.6.5 PDF CSV)

Indirect Costs (Society/Employers)

Indirect costs associated with lost wages for persons ages 18 to 64 are not calculated for persons with a musculoskeletal injury. However, musculoskeletal injuries are a primary cause of lost work days by persons in the labor force. Since 1992, musculoskeletal disorders (MSD) have accounted for nearly one-third of workplace injuries involving days away from work. In addition, MSD injuries consistently across the years result in more median days away from work than all workplace injuries. In 2016, MSDs had a median of 12 days away from work compared to a median of 8 days for all injuries, which includes the MSDs in this median. (Reference Table 5D.1 PDF CSV and Table 5D.2.2 PDF CSV)

Workforce Implications

Musculoskeletal workplace injuries are a major concern, accounting for a large proportion of all nonfatal injuries that result in days away from work. Even though long-term trends show significant reductions in the total number of worker injuries each year, the proportion that are musculoskeletal related (MSD, which include fractures, bruises/ contusions, and amputations) continues to account for more than one-half of all worker nonfatal injury cases involving days away from work. In addition to the cost of medical care for these injuries, the cost of lost wages and the potential for long-term impairment negatively impacting worker productivity are enormous.


  • Fourth Edition

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