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4.1 General Cost Estimation Framework

Cost Estimates Based on System-Provided Data Only

Estimated lifetime medical and work loss costs that are based exclusively on system-provided data involve two primary components:

1. national injury fatality data and ED injury surveillance data for the year 2010;
2. unit (per case) lifetime medical and work loss cost estimates expressed in year 2010 U.S. prices.

Details on the comprehensive national injury fatality data and the nationally representative ED injury surveillance data are provided in Section 5. The estimated unit lifetime medical costs (e.g., treatment and rehabilitation) and lifetime work loss costs (e.g., lost wages, benefits, and self-provided household services) were developed under a contract with the Pacific Institute for Research and Evaluation (PIRE). The methodology used to develop these unit cost estimates is documented in the PIRE methods report⁹ and in Finkelstein et al 2006.¹⁰

The calculation of total and average cost estimates based on system-provided data is supported by several static data sets with unit cost estimates assigned to individual injury records from the national data sets. For details about how unit cost estimates were assigned to injury-related death records, see Section 4.2. For details about how unit cost estimates were assigned to records representing hospitalizations and ED visits, see Section 4.3.

The unit cost estimates assigned to individual injury records are dynamically aggregated to arrive at nationwide total cost estimates (lifetime medical, lifetime work loss, and/or both combined), as well as corresponding average (per case) cost estimates for each of these cost-of-injury categories. For injury-related deaths, total and average costs can also be estimated for multi-state regions and individual states.

All cost estimates based on system-provided data represent injury outcomes for the year 2010, and are expressed in year 2010 prices (the current base year for WISQARS Cost of Injury Reports). Nationwide cost estimates are always expressed in terms of U.S. prices. Regional cost estimates (available for injury-related deaths only) can be expressed in terms of U.S. prices (the default) or region-specific prices. Cost estimates for individual states (available for injury-related deaths only) can be expressed in terms of U.S. prices (the default), region-specific prices, or state-specific prices. For general guidelines about how cost estimates expressed in U.S., region-specific, or state-specific prices should be interpreted, see Section 2.7. For further details regarding how cost estimates are calculated in terms of U.S., region-specific, or state-specific prices, see Section 4.4.

Cost Estimates That Combine System-Provided Data and User-Provided Data

Cost estimates that incorporate user-provided case count data also rely on the system-provided data described above. The general framework for calculating such cost estimates is as follows:

• system-provided data are used to generate preliminary average cost estimates stratified at the lowest level indicated;
• the preliminary system-generated average cost estimates are then multiplied by corresponding user-entered case counts to arrive at total cost estimates at the lowest level of stratification;
• total cost estimates at higher levels of stratification (if any) are determined by summing lower-level totals; average cost estimates are not calculated at higher levels of stratification.

Unlike cost estimates based exclusively on system-provided data, cost estimates that incorporate user-provided data can be expressed in prices indexed to years other than the current base year of 2010. For further details about index years see Section 2.4.

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WISQARS Cost of Injury Reports