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