Injury in Australia

Burden of disease measures the impact of illness and injury through time spent in ill health and premature death. In 2022, injuries were the 6^th highest cause of total disease burden in Australia, accounting for 8% of total burden. Most of the injury burden (83%) was due to premature death (fatal burden), while 17% was due to years lived in ill health or with disability (non-fatal burden).

Over two-thirds (70%) of the total burden due to injuries was experienced by males, while 30% was experienced by females. Injuries accounted for 11% of total burden for males, compared to 5% for females. Suicide and self-inflicted injuries accounted for 36% of total injury burden, followed by falls (19%), poisoning (16%), road traffic injuries – motor vehicle occupants (8%), and homicide and violence (4%).

Spending on injuries is captured in the Disease expenditure database, including costs from injury hospitalisations and treatment in primary care settings. In 2019-20, a total of $140.4 billion was allocated to health conditions, of which 8% ($10.7 billion) was spent treating and managing injury. The majority occurred in hospital settings ($8.6 billion, including emergency departments and outpatient clinics), with approximately $584 million occurring in general practice, $484 million in medical imaging and $223 million in PBS expenditure. These estimates may reflect greater data capture for hospital presentations in the disease expenditure analyses, as many injuries are treated in settings such as physiotherapy or sports medicine clinics, or self managed, which may not be fully captured in these estimates.

Injury costs are reported by both the nature and cause of injury. By nature of injury (excluding ‘other’ injuries), soft tissue injuries, hip fractures, tibia and ankle fractures, dislocations, and poisoning had the highest spending. In terms of the cause of injury (excluding ‘other’ causes), spending was highest for falls, road traffic injury – motor vehicle occupants, homicide and violence, suicide and self-inflicted injuries, and road traffic injury - motorcyclists.

From 2017–18 to 2021–22 the age-standardised rate of injury hospitalisations fell marginally by an annual average of 1%.  The volatility seen between 2020 and 2022 is probably related to the social disruptions caused by COVID-19. From 2012–13 to 2016–17, the rate of hospitalisations increased by an annual average of 2.8%.

There is a break in the hospitalisations time series between 2016–17 and 2017–18 due to a change in data collection methods (see the technical notes for more details).

For injury deaths, the age-standardised rate in 2020–21 was 0.6% lower than a year earlier. Between 2011–12 and 2020–21,  there was an average annual increase in the rate of 0.2% (Figure 2).

Figure 2: Number and age-standardised rate of injury hospitalisations and deaths, by year

For more detail, see Data tables C1–3 and F1–4.

The total number of hospitalisations for injuries does not usually change much with the seasons. Data for the three most recent years suggest slightly lower numbers during July to October and a dip in January. The January dip in 2021–22 was larger than in the previous two years.

From March 2020, a range of restrictions on travel, business and social interactions were introduced in response to COVID-19.  These restrictions coincided with a temporary drop in injury hospitalisations (Figure 3).

For some injury cause categories, the number of hospitalisations does change with the seasons – explore the interactive display.

Figure 3: Seasonal differences in injury hospitalisations, 2019–20 to 2021–22

Notes
1. Admission counts have been standardised into two 15-day periods per month.
2. A scale up factor has been applied to June admissions to account for cases not yet separated.

Source: AIHW National Hospital Morbidity Database.

For more detail, see Data tables A1–3 and D1–3.

Cause and sex

The various causes of injury tend to affect one sex more than the other, usually males more than females. Males had higher rates of injury hospitalisation across all causes except falls and intentional self-harm.

Some causes, such as accidental poisoning, showed a relatively small difference in impact between the sexes, while others showed a large difference (Figure 5).

The largest differences in hospitalisation rates in 2021–22 were from:

• forces of nature (the rate for males was 2.8 times that for females) and
• contact with objects (the rate for males was 2.7 times that for females).

Males had higher rates of injury death than females across every cause category in 2020–21. For males, the highest age-standardised rate was for suicide, while for females it was for falls.

Figure 5: Injury hospitalisations and deaths, by cause and sex

For more detail, see Data tables A1–3, D1–3 and B1–34.

Cause and age

Different age groups face different injury risk factors. As a result, injuries from the various causes occur in different proportions in each age group.

For injury hospitalisations in 2021–22:

• falls and contact with objects both placed in the top 3 causes across all life-stage age groups (Figure 6)
• falls accounted for 44% of all hospitalised injuries in the 0–4 age group, 14% in the 15–24 age group and 77% for the 65-and-over group.

For injury deaths in 2020–21:

• Transport was the top cause for the two youngest age groups, suicide was the top cause for those aged between 15 and 64, and falls was the top cause for those aged 65 years and over
• falls was the cause for which the rate varied most across the life-stages, ranging from less than 1 death per 100,000 for children aged 0–4 up to 130 deaths per 100,000 for people aged 65 and over (Figure 6).

Figures 6 illustrates which causes of injury are most common for each life-stage age group. Hover over a point of interest for more detail.

Figure 6: Top 5 causes of injury leading to hospitalisation and death, by age

For more detail, see Data tables A1–3 and B1–34.

Each cause is discussed further on its own page.

There are many ways the severity, or seriousness, of an injury can be measured. Some of the ways to measure the severity of hospitalised injuries are:

• number of days in hospital
• time in an intensive care unit (ICU)
• time on a ventilator
• in-hospital deaths.

Average length of hospital stay

In 2021–22, the most severe injuries in terms of average number of days in hospital were due to falls (7.1 days), thermal causes (5.2 days), and transport accidents (4.6 days) (Figure 7).

The average length of stay may be influenced by the age of those injured, with younger people staying fewer days in hospital than older people across all cause categories. Older people tend to recover more slowly and are more likely to have additional health problems or complications. This particularly affects the statistics for causes with higher proportions of older people, such as falls.

Figure 7: Average number of days in hospital, by cause of injury, 2021–22

Note: Includes admissions that are transfers from 1 hospital to another or transfers from 1 admitted care type to another within the same hospital, except where care involves rehabilitation procedures.

Source: AIHW National Hospital Morbidity Database.

Intensive care

Dropping from 12,900 in 2020-21, about 10,700 injury hospitalisations (2.0% of all cases) involved a stay in an intensive care unit (ICU) in 2021–22. Injuries due to intentional self-harm, undetermined intent and accidental poisoning were most likely to result in time in an ICU (Figure 8).

Continuous ventilatory support

Continuous ventilatory support or ‘life support’, is when a patient breathes via an artificial airway with the aid of a machine.

About 6,000 injury hospitalisations (1.1% of all cases) involved continuous ventilatory support in 2021–22. Most patients needing this level of support will be in an ICU.

Injuries due to intentional self-harm, undetermined intent and drowning and submersion were most likely to result in continuous ventilatory support (Figure 8).

Figure 8: Percentage of injury hospitalisations requiring time in an ICU and continuous ventilatory support, by cause of injury, 2021–22

Source: AIHW National Hospital Morbidity Database.

In-hospital deaths

When an injured person is admitted to hospital, and dies despite the treatment provided, that can be an indication of the severity of their injuries. Figure 9 compares the causes of injury by the rate at which people died in hospital. Choking and suffocation had the highest rates of in-hospital death.  

Figure 9: In-hospital deaths per 1,000 cases, by cause of injury, 2021–22

Note: Rates for the following causes were not published because of small numbers: Drowning and submersion, forces of nature, overexertion and electricity and air pressure.
Source: AIHW National Hospital Morbidity Database.

For more detail, see Data tables A13–15.

This section summarises:

• the parts of the body injured in hospitalisations and
• the main types of injury.

Body part injured

In 2021–22, the head or neck was the body part most often identified as the main site of injury in hospitalisations (Figure 10). To some extent this probably reflects the serious nature of head and neck injuries.

Figure 10: Injury hospitalisations by main body part injured, 2021–22

Notes

1. Main body part refers to the principal reason for hospitalisation.
2. ‘Trunk’ includes thorax, abdomen, lower back, lumbar spine and pelvis.
3. Number and percentage of injuries classified as Other, multiple, and incompletely specified body regions and Injuries not described in terms of body region not shown – see Data table A11.

Source: AIHW National Hospital Morbidity Database.

Different causes tend to lead to different parts of the body being injured. Figure 11 shows the three most common body parts injured for some of the most common cause categories.

Figure 11: Top 3 body parts injured as a proportion of hospitalisations, for selected causes, 2021–22

Note: ‘Trunk’ includes thorax, abdomen, lower back, lumbar spine and pelvis.

For more detail, see Data table A11.

Types of injury

Different causes tend to lead to different types of injury. Figure 12 shows the most common types of injury in hospitalisations for selected causes. Fractures were the most common type for injuries caused by falls, transport and assault, while open wounds were the most common from contact with objects and contact with living things.

Figure 12: Top 3 types of injury leading to hospitalisation as a proportion for selected causes, 2021–22

For more detail, see Data table A11.

Among Aboriginal and Torres Strait Islander people, there were 31,600 hospitalisations for injury in 2021–22, and 500 deaths in 2020–21. Falls and assault were the two most common causes of injury that led to hospitalisations (Table 1); suicide was the most common cause of injury deaths (Table 2).

Indigenous males, compared with Indigenous females were:

• 1.2 times as likely to be hospitalised due to an injury in 2021–22
• 1.9 times as likely to die from an injury in 2020–21.

Injury hospitalisation rates were highest for Indigenous Australians in the 25–44 age group (Figure 13).

Note: All-causes total includes hospitalisations where the cause has undetermined intent or is missing, or where the cause is not elsewhere classified.

Source: AIHW National Hospital Morbidity Database.

Table 2: Injury deaths by cause, Indigenous Australians, 2020–21

Notes

1. Deaths data only includes data for New South Wales, Queensland, Western Australia, South Australia, and the Northern Territory.
2. The sum of the counts by cause may be greater than the total number of injury deaths because some deaths have multiple causes.

Source: AIHW National Mortality Database.

For more detail, see Data tables A4–A6 and D4–D8.

Indigenous and non-Indigenous Australians

Indigenous Australians, compared with non-Indigenous Australians, using age-standardised rates, were:

• 2.1 times as likely to be hospitalised due to an injury in 2021–22 (Table 3)
• 1.8 times as likely to die from an injury in 2020–21 (Table 4).

The cause of injury hospitalisation with the largest difference in rates between Indigenous and non-Indigenous Australians was assault, which was 14 times as high in the Indigenous population. Rates of injury among Indigenous Australians for intentional self-harm, thermal causes, accidental poisoning, contact with living things, undetermined intent and exposure to forces of nature were all more than twice as high as those for non-Indigenous Australians (Table 3).

Note:

1. Rates are age-standardised per 100,000 population.
2. ‘Non-Indigenous Australians’ excludes cases where Indigenous status is missing or not stated.

Source: AIHW National Hospital Mortality Database.

The cause of injury death with the largest difference in rates between Indigenous and non-Indigenous Australians was accidental poisoning, which was 3.0 times as high in the Indigenous population. Rates of death for transport accidents and suicide were also more than twice as high for Indigenous Australians (Table 4). Readers are advised to use caution when using the rates in categories with low numbers of deaths.

Table 4: Age-standardised rates of injury death (per 100,000) for selected causes, by Indigenous status, 2020–21

Age standardised rates for other categories not publishable because of small numbers, confidentiality or other concerns about the quality of the data.

Notes:

1. Rates are age-standardised per 100,000 population.
2. Deaths data only includes data for New South Wales, Queensland, Western Australia, South Australia, and the Northern Territory.
3. ‘Non-Indigenous Australians’ excludes cases where Indigenous status is missing or not stated.

Source: AIHW National Mortality Database.

The rate of injury hospitalisations was highest among the 25–44 life-stage age group for Indigenous Australians and among the 65-and-over age group for non-Indigenous Australians (Figure 13).

Figure 13: Injury hospitalisations and deaths, by Indigenous status, sex and age group

For more detail, see Data tables A4–6 and D4–6.

The Aboriginal and Torres Strait Islander Health Performance Framework includes a measure discussing Injury and Poisoning.

Areas of Australia which are more remote tend to have higher rates of hospitalisation and death from injury than less remote areas. People living in Very remote areas, compared with people living in Major cities, were:

• 2.2 times as likely to be hospitalised due to an injury in 2021–22 (Table 5)
• 2.2 times as likely to die from an injury in 2020–21  (Table 6).

Note: Rates are age-standardised per 100,000 population.

Source: AIHW National Hospital Morbidity Database.

Note: Rates are age-standardised per 100,000 population.

Source: AIHW National Mortality Database.

Cause of injury by remoteness

The cause of injury with the largest difference in hospitalisation rates between remoteness areas was assault, with the rate for Very remote areas 19 times that of Major cities (Table 7).

Note: Rates are age-standardised per 100,000 population.

Source: AIHW National Hospital Mortality Database.

Age-standardised rates of death by cause of injury in Remote and Very remote areas need to interpreted with caution because of low numbers of deaths in some categories. 

For further detail see Data tables A7–9 and D7–9.

Remoteness by age

The highest rate of injury hospitalisations was among the 15–24 life-stage age group living in Very remote areas of Australia (Figure 14).

Figure 14: Injury hospitalisations and deaths, by remoteness, by age group and sex

For more detail, see Data tables A7–9 and D9–10.

For information on how the statistics were calculated by remoteness, see the technical notes.

Technical notes: how the data were calculated

Data tables: download full data tables

Glossary
 

Sports injury (topic)

The first year of COVID-19 in Australia: direct and indirect health effects

MyHospitals

Life expectancy & deaths (topic)

Disease expenditure in Australia 2019-20

Preventative Health resources from the Australian Government

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