Original research
The economic burden of time-loss injuries to youth players participating in week-long rugby union tournaments

https://doi.org/10.1016/j.jsams.2014.06.015Get rights and content

Abstract

Objectives

Rugby Union (“rugby”) is a popular sport with high injury risk. Burden of injury is described by the incidence and severity of injury. However reports have ignored the monetary cost of injuries. Therefore the aim of this study was to describe the monetary cost associated with youth rugby injuries.

Design

This descriptive study quantified medical treatments of injured players at the South African Rugby Union Youth tournaments in 2011/2012 and the days of work parents missed as a result of the injuries. A health insurer used these data to calculate associated costs.

Methods

Legal guardians of the 421 injured players were contacted telephonically on a weekly basis until they returned to play. Treatments costs were estimated in South African Rands based on 2013 insurance rates and converted to US$ using purchasing power parities.

Results

Of the 3652 players, 2% (n = 71) sought medical care after the tournament. For these players, average treatment costs were high (US$731 per player, 95% CI: US$425–US$1096), with fractures being the most expensive type of injury. Players with medical insurance had higher costs (US$937, 95% CI: US$486–US$1500) than those without (US$220, 95% CI: US$145–US$302).

Conclusions

Although a minority of players sought follow-up treatment after the tournaments, the cost of these injuries was high. Players without medical insurance having lower costs may indicate that these players did not receive adequate treatment for their injuries. Injury prevention efforts should consider injuries with high costs and the treatment of players without medical insurance.

Introduction

Participation in physical activity has numerous health benefits for children.1 However, physical activity can also pose the risk of health detriments, such as injury, the likelihood of which may vary depending on the mode of physical activity.2 This potential burden of injury may discourage participation in a particular sport, unless preventative measures are introduced effectively.2 Of all international sports, Rugby union (“rugby”) is arguably amongst the most popular, for all age groups, including youth.3

To better understand the injury problem, both the incidence and severity of a particular sport-related injury need to be accurately quantified.2 The incidence of injury can be described by calculating the number of new injuries that occur taking into account the participation levels of that sport.4 “Severity” could be described using six criteria: (i) nature of sports injury, (ii) duration and nature of treatment, (iii) sporting time lost, (iv) working time lost (of the injured individual or injured individual's parent/legal guardian), (v) permanent damage and (vi) monetary cost.4

In general, rugby carries a higher incidence and severity of injury to the participant,5 in comparison to other popular sports.6 Although other sports,7, 8, 9 including rugby league,10, 11, 12 have reported on injury-related monetary costs, this analysis is yet to be performed in rugby union.

Besides being an important descriptor of severity, the monetary cost of injury provides valuable information to drive and evaluate the effectiveness of preventative measures.8 In South Africa, the BokSmart programme is responsible for implementing injury prevention strategies in rugby union13 and information on the costs of injuries is therefore essential for guiding future policies emanating from this nationwide programme. Therefore, the aim of this study is to describe the monetary cost of rugby-related injuries in a youth cohort.

Section snippets

Methods

The population studied included the combined attendees of the South African Rugby Union (SARU) Youth Weeks in 2011 and 2012, and, depending on the tournament, players ranged between the ages of 12 and 18 years old. These tournaments showcase the most talented players in each age group, and have been described in more detail elsewhere.14 Written informed consent was provided by the player or by the player's parent/legal guardian if the player was younger than 18 years of age. All information was

Results

The overall injury rates (Table 1) were not significantly different between the various age groups (under-13 to under-18), with a combined rate of 54.6 injuries per 1000 h (95% CIs: 49.5–59.8 injuries per 1000 h) of tournament play resulting from 436 injury events in 7945 exposure hours. Of the 436 injury events, the most common injury was a joint/ligament/tendon injury which accounted for 31% of all injuries. The joint/ligament/tendon injuries were the most common at all age groups except for

Discussion

The main finding of this paper was that the monetary cost to players seeking follow-up treatment was, on average US$731 (95% CIs: US$425–US$1096). These high costs were incurred by a relative minority of players: 17% (n = 71 of 421) of injured players and 2% (n = 71 of 3652) of the total tournament players. If these costs were divided by all the tournament players (n = 3652) instead of just those that sought follow-up treatment, the costs would be less of a burden (US$14 instead of US$731, on

Conclusion

Although the estimation of costs associated with the medical treatments described in the present study involved many assumptions due to the circumstances in which they were collected, this study is the first to quantify and compare monetary cost as an indication of injury burden in youth rugby union.

In particular BokSmart, the national injury prevention programme in South Africa,13 should consider the high monetary costs of fractures and upper extremity injuries, in addition to injuries of

Practical implications

  • This study describes the monetary cost of rugby union injuries of youth rugby players in South Africa seeking follow-up treatment for injuries sustained at national tournaments.

  • The costs are estimated from a health insurer's perspective and thus are a conservative estimate of what these injuries could cost the parents/legal guardians of the injured players.

  • As the monetary costs of these injuries can be high, a description of injury severity/burden might be incomplete without this aspect of

Acknowledgments

The authors would like to thank Ms Jill Borreson and Ms Kirsten Blair from Discovery Health for their assistance in calculating the medical costs related to these injuries and the treatments associated with the particular injuries.

References (23)

  • J.H.M. Brooks et al.

    Recent trends in rugby union injuries

    Clin Sports Med

    (2008)
  • D.A. King et al.

    Neck back and spine injuries in amateur rugby league: a review of nine years of Accident Compensation Corporation injury entitlement claims and costs

    J Sci Med Sport

    (2011)
  • P.C. Hallal et al.

    Adolescent physical activity and health: a systematic review

    Sports Med

    (2006)
  • W. Van Mechelen et al.

    Incidence, severity, aetiology and prevention of sports injuries. A review of concepts

    Sports Med

    (1992)
  • W. Van Mechelen

    The severity of sports injuries

    Sports Med

    (1997)
  • S. Williams et al.

    A meta-analysis of injuries in senior men's professional Rugby Union

    Sports Med

    (2013)
  • C. Fuller et al.

    The application of risk management in sport

    Sports Med

    (2004)
  • S.B. Knowles et al.

    Cost of injuries from a prospective cohort study of North Carolina high school athletes

    Inj Prev

    (2007)
  • D.C.M. Collard et al.

    Economic burden of physical activity-related injuries in Dutch children aged 10–12

    Br J Sports Med

    (2011)
  • S.L. Schmikli et al.

    National survey on sports injuries in the Netherlands: target populations for sports injury prevention programs

    Clin J Sport Med

    (2009)
  • D. King et al.

    A retrospective review over 1999 to 2007 of head, shoulder and knee soft tissue and fracture dislocation injuries and associated costs for rugby league in New Zealand

    Int J Sports Med

    (2011)
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