Implementation of an Injury Prevention Program in NCAA Division I Athletics Reduces Injury-Related Health Care Costs

Robert L Parisien; Marisa Pontillo; Ali S Farooqi; David P Trofa; Brian J Sennett

doi:10.1177/23259671211029898

Implementation of an Injury Prevention Program in NCAA Division I Athletics Reduces Injury-Related Health Care Costs

Orthop J Sports Med. 2021 Sep 16;9(9):23259671211029898. doi: 10.1177/23259671211029898. eCollection 2021 Sep.

Authors

Robert L Parisien¹, Marisa Pontillo², Ali S Farooqi³, David P Trofa⁴, Brian J Sennett²

Affiliations

¹ Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts, USA.
² Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
³ Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁴ Department of Orthopaedic Surgery, Columbia University Medical Center, New York, New York, USA.

Abstract

Background: The estimated cost per year of injuries in collegiate athletics has been reported to be billions of dollars in the United States. Injury prevention programs are often assessed only by their ability to reduce injuries, and there is little evidence of any potential reduction in associated health care costs.

Purpose: To investigate changes in injury-related health care costs at a National Collegiate Athletic Association (NCAA) Division I university after the implementation of an injury prevention program.

Study design: Cohort study; Level of evidence, 3.

Methods: Included were 12 sports teams that used the injury prevention program (user group) and 16 teams that did not implement the program (nonuser group). The injury surveillance and prevention system (Sparta Science) utilized a commercially available force-plate system to assess kinematic variables, flag high-risk athletes, and guide individual conditioning programs. Data were obtained from 3 academic years before (2012-2014) and 2 academic years after (2015-2016) implementation of the Sparta Science system. The number of injuries and associated health care costs (surgery, clinic visits, imaging, and physical therapy) were compared between users and nonusers.

Results: Total average annual injuries did not change significantly between users and nonusers after implementation of the program; however, users demonstrated a 23% reduction in clinic visits as compared with a 14% increase for nonusers (P = .049). Users demonstrated a 13% reduction in associated health care encounters, compared with a 13% increase for nonusers (P = .032). Overall health care costs changed significantly for both groups, with an observed 19% decrease ($2,456,154 to $1,978,799) for users and an 8% increase ($1,177,542 to $1,270,846) for nonusers (P < .01 for both). Costs related to associated health care encounters also decreased by 20% for users as compared with a 39% increase for nonusers (P = .027).

Conclusion: This study demonstrated the ability to significantly reduce injury-related health care costs in NCAA Division I athletes via a comprehensive injury surveillance and prevention program utilizing force-plate technology. Given the substantial and appropriate focus on value of care delivery across the US health care system, we recommend the continued study of sports injury surveillance and prevention programs for reducing injury-related health care costs.

Keywords: athlete; cost reduction; economic analysis; injury prevention; sports injury.