Systematic review of health utility losses from injuries and violence

Background Health utility values (0–1 scale) underpin quality-adjusted and disability-adjusted life years, used to quantify illness burden and evaluate intervention cost-effectiveness. This systematic review summarised available health utility estimates associated with non-fatal acute injuries and violence to support economic analysis. Methods The authors identified peer-reviewed studies through December 2025 reporting diagnosis-specific health utilities (1=full health) or disability weights (0=full health) from generic preference-based instruments (eg, EQ-5D) among general population samples. The primary outcome was the range of utility values by injury diagnosis and instrument. Body region, mechanism, intent, time since injury, geography, sample size, respondent type and contact method are also reported. Results The authors summarised 468 estimates from 54 articles. Fractures, burns and traumatic brain injuries were most frequently studied; mechanism and intent were rarely reported. Utilities by diagnosis varied by study population, body region and time since injury. EQ-5D utilities for fractures ranged from 0.990 (near-zero loss) among children 9 months after an upper extremity fracture in the Netherlands to 0.139 (substantial loss) among older adults with pre-treatment proximal femoral fracture in Colombia. Disability weights for fractures ranged from 0 (no loss) for rib fractures 1 year post-treatment to 0.431 (substantial loss) during the acute phase of a pelvic fracture, assessed by general population respondents based on health state descriptions. Conclusion This review offers streamlined access to utility inputs for economic analyses informing injury and violence prevention decisions. Analysts can consider available evidence broadly, select values matching the analytic context and use sensitivity analyses to strengthen validity and interpretability.