Abstract
Dog bites are a global health issue that can lead to severe health outcomes. This study aims to describe the incidence and sociodemographics of patients admitted to English National Health Service (NHS) hospitals for dog bites (1998–2018), and to estimate their annual direct health care costs. An analysis of patient level data utilising hospital episode statistics for NHS England, including: temporal trends in annual incidence of admission, Poisson models of the sociodemographic characteristics of admitted patients, and direct health care cost estimates. The incidence of dog bite admissions rose from 6.34 (95%CI 6.12–6.56) in 1998 to 14.99 (95%CI 14.67–15.31) admissions per 100,000 population in 2018, with large geographic variation. The increase was driven by a tripling of incidence in adults. Males had the highest rates of admission in childhood. Females had two peaks in admission, childhood and 35–64 years old. Two percent (2.05%, 95%CI 0.93–3.17) of emergency department attendances resulted in admission. Direct health care costs increased and peaked in the financial year 2017/2018 (admission costs: £25.1 million, emergency attendance costs: £45.7million). Dog bite related hospital admissions have increased solely in adults. Further work exploring human–dog interactions, stratified by demographic factors, is urgently needed to enable the development of appropriate risk reduction intervention strategies.
Highlights
Dog bites are a global health issue that can lead to severe health outcomes
A third of those bites required medical treatment, 58.9% of those attended accident and emergency departments (A&E), and only a very small proportion of individuals resulted in hospital admission (1 out of 178 bites); though these were based on a small sample size[16]
The incidence of dog bite admissions rose from 6.34 admissions per 100,000 population in 1998 to 14.99 in 2018 (Fig. 1)
Summary
Dog bites are a global health issue that can lead to severe health outcomes. This study aims to describe the incidence and sociodemographics of patients admitted to English National Health Service (NHS) hospitals for dog bites (1998–2018), and to estimate their annual direct health care costs. Two analyses of national electronic health records describing dog bites in England have been conducted; both published by NHS Digital (formally Health and Social Care Information Centre)[18,19] They focus on hospital admissions, in all NHS England hospitals, due to a ‘dog bite or strike’ using Hospital Episode Statistics data, and presented annual increases in absolute case numbers. The rate of admission was 2.6 times higher in the most deprived neighbourhoods compared to the least deprived[19] These results offer only a static cross-sectional view of limited aspects of hospital records and deliver no insight into temporal trends, and no modelling was performed to explore which demographic variables were associated with dog bite incidence. They estimated direct costs of dog bite admissions to be about £10 million in 2013 This figure does not include the whole national dog bite admissions population or that attending accident and emergency departments. If the incidence of dog bites is rising, the calculation of improved cost figures is needed so that injury prevention strategies can be justified, and their success measured
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