Incidence of injuries in Norway: linking primary and secondary care data

Abstract

Aims: Most studies of injury incidence underestimate the total burden of injury, as they do not include injuries treated in primary care. The aim of this study was to measure the total incidence of medically treated injuries in Norway. We further investigated the epidemiology of injuries treated in primary and secondary care. Methods: We collected individual-level data on injury diagnoses from the Norwegian Patient Registry and the national registry dataset for reimbursement of primary care providers for the period 2009–2014, and estimated the annual incidence of patients registered with an injury diagnosis in either or both of these registries. We also converted ICD-10 codes in secondary care into ICPC-2 codes to compare the types of injuries treated in primary and secondary care. Results: The annual incidence of medically treated injuries in Norway was 125 patients per 1000 inhabitants. Fifty-five per cent of injured patients received treatment exclusively in primary care. We observed stable time trends over the six-year period. Incidence rates were higher in primary care for the youngest children and in middle adulthood, but were higher in secondary care for older people. Overall, injury incidence was higher for men, but women became more injury prone with age. We only observed this gender reversal in secondary care. With the exception of fractures, all injury types were predominantly treated in primary care. Conclusions: A substantial proportion of injured patients in Norway are treated exclusively in primary care. The demographic profile of these patients differs from those treated in secondary care.