Trends in Fatal and Non-Fatal Injuries in the United States: Analyzing Incidence and Costs from 2015 to 2022

Background In addition to the emotional toll on patients, families, and communities, injury is financially costly for the United States healthcare system. Costs associated with injury can be medical or non-medical, with medical costs limited to acute medical care and non-medical costs including work or quality of life losses. The objective of this study is to characterize recent incidence and cost trends for fatal and non-fatal injuries in the United States. Methods This descriptive retrospective study analyzes data published by the Centers for Disease Control and Prevention (CDC) Web-Based Injury Statistics Query and Reporting System (WISQARS) database from 2015–2022. The top ten injury types across all age groups by total cost in three injury outcome categories were compared, with the top three types in each category further discussed. Results Unintentional drug poisoning was the costliest fatal injury at $1.13T in 2022, a 123% increase from its total cost in 2015 ($503B). Suicide by drug poisoning was the only fatal injury type to decrease in total cost. Unintentional falls were the costliest non-fatal hospitalization-and-release and emergency department-and-release injury at $474B and $931B in 2022, respectively. Relative to fatal injuries, a greater proportion of costs were attributed to medical care in the non-fatal injury categories. Conclusions There is considerable heterogeneity in the trends of injury outcomes (i.e. fatal, non-fatal) and specific injury types (i.e. unintentional falls, firearm suicides), driven by changes in incidence and per-injury cost. Unintentional drug overdose and unintentional falls are the costliest fatal and non-fatal injuries, respectively, by wide margins. Recent injury incidence and cost trends highlight increased mortality, as well as increased hospitalization with decreased emergency department utilization for non-fatal injuries.