Abstract
BackgroundRepeated injuries, as known as injury recidivism, pose a significant burden on population health and healthcare settings. Therefore, identifying those at risk of recidivism can highlight targeted populations for primary prevention in order to improve health and reduce healthcare expenditures. There has been limited research on factors associated with recidivism in the U.S. Using a population-based sample, we aim to: 1) identify the prevalence and risk factors for injury recidivism among non-institutionalized adults; 2) investigate the trend in nationwide recidivism rates over time.MethodsUsing the Medical Expenditure Panel Survey (MEPS), 19,134 adults with at least one reported injury were followed for about 2 years. Reported injuries were those associated with healthcare utilization, disability days or any effects on self-reported health. The independent associations between risk factors for recidivism were evaluated incorporating a weighted logistic regression model.ResultsThere were 4,136 recidivists representing over nine million individuals in the U.S. over a 2-year follow-up. About 44 % of recidivists sustained severe injuries requiring a hospitalization, a physician’s office visit or an emergency department visit. Compared with those who sustained a single injury, recidivists were more likely to be white, unmarried, reside in metropolitan areas, and report a higher prevalence of chronic conditions. Age, sex, race/ethnicity, marital status, urbanicity, region, diabetes, stroke, asthma and depression symptoms were significant predictors of recidivism. Significant interaction effects between age and gender suggested those in the 18–25 age group, the odds of being a recidivist were 1.45 higher among males than females adjusting for other covariates. While having positive screens for depression in both follow-up years was associated with 1.46 (95 % CI = 1.21–1.77) higher odds of recidivisms than the reference group adjusting for other variables.ConclusionsWe observed a higher recidivism rate among injured individuals in this study than previously reported. Our findings emphasize the pressing need for injury prevention to reduce the burden of repeated injuries. Preventative efforts may benefit from focusing on males between 18 and 25 years of age and those with comorbidities such as diabetes, stroke and depression.
Highlights
Repeated injuries, as known as injury recidivism, pose a significant burden on population health and healthcare settings
While previous literature has focused on identifying risk factors for sustaining injuries (Rasouli et al 2011; Rivara et al 2015), much remains unclear about factors associated with injury recidivism
While recidivists were more likely than non-recidivists to report diabetes (10.9 vs. 8.6 %, p < 0.01), asthma (15.2 vs. 11.6 %, p < 0.01) and, smoking (25.3 vs. 22.3 %, p < 0.01), there were no difference in the frequency of coronary health diseases or alcohol related conditions between the two groups
Summary
As known as injury recidivism, pose a significant burden on population health and healthcare settings. Identifying those at risk of recidivism can highlight targeted populations for primary prevention in order to improve health and reduce healthcare expenditures. (2013) Adding to this burden is the fact that injured patients remain at risk for injury reoccurrence, as known as injury recidivism (Caufeild et al 2004; Kaufmann et al 1998). Recidivism rates in the literature vary with estimates between 1 % and 44 % (Caufeild et al 2004) More comprehensive approaches such as the use of population-based surveys may overcome such hurdles in shedding more light on the burden of injury recidivism
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