Does the burden of injuries vary between small and neighbouring municipalities? -testing a new surveillance system based not only in hospitals.

Background: Regional preventive programs usually assume that there are no important differences in the pattern and burden of injuries between municipalities. Few studies have shown that there might be differences. Objective: Describe and assess the pattern and the burden of non-fatal injuries between small and neighbouring municipalities. Design: A retrospective analysis of the database from Skaraborg´s Local Injury Surveillance System, SLISS, which includes all the health care services in the county i.e. primary health care centres and hospitals. Methods: Mean Standardised Injury Rates (m-SIRs) by sex and adjusted by age were used to compare four municipalities. Skovde was used as the reference municipality in the analysis. Results: A total of 47,922 injuries were registered in four municipalities between the year 2000 and 2004. The distribution of injuries, regarding type, body part injured, mechanism and place of occurrence, were similar between the municipalities in the study. However, the burden of injuries, in terms of incidence, varied significantly between them. The highest difference from Skovde was in the injuries that occurred at work. The m-SIRs at work in Toreboda were 2.4 (99%CI 1.6-3.9) and 2.7 (99%CI 1.2-8.1) for males and females respectively. Mariestad had higher differences from Skovde in injuries by jamming/cuts with m-SIRs of 1.9 (99%CI 1.5-2.4) and 2.0 (99%CI 1.5-2.7) for males and females respectively. Males´ injury rates in the head/neck were significantly lower in Skovde. Toreboda´s m-SIRs was 1.7 (99%CI 1.3-2.3), Mariestad had 1.5 (99%CI 1.0-2.2) and in Tidaholm was 1.5 (99%CI 1.1-1.9). Conclusions: Small and neighbouring municipalities had overall a similar distribution of the injuries by sex. However, some important differences in the burden of injuries were identified and those should be taken into consideration for preventive efforts.