Differences in Total Healthcare Costs Among Injured and Non‐Injured Danish Adolescent Handball Players: Data From the Health and Performance Promotion in Youth Sport ( <scp>HAPPY</scp> ) Cohort

Sports injuries often occur early in life with lasting consequences, but information on healthcare costs related to injuries remains limited. This retrospective cohort study compared total healthcare costs for adolescent handball players (aged 11-17) participating in the one-season HAPPY study with sport-related injuries to those without. Healthcare costs were sourced from Danish health registers over 3 years, covering expenses from general practitioners, other primary care, and hospital services. We employed a two-part model, with logistic regression to estimate the likelihood of incurring healthcare costs and a GLM (gamma family, log link) to calculate the expected mean cost among individuals with costs. Part 1: injury-exposed players had 1.4 (95% CI 1.0-1.8) higher odds of utilizing other primary care providers and 1.6 (95% CI 1.2-2.3) higher odds of using hospital services, compared to unexposed players. Injured girls had 2.0 (95% CI 1.3-3.1) higher odds of using hospital services, while injured boys had 1.5 (95% CI 0.9-2.3) higher odds of utilizing other primary care providers, compared to uninjured players. Players with sudden-onset injuries had 2.6 (95% CI 1.6-4.0) higher odds of using hospital services, and those with gradual-onset injuries had 1.5 (95% CI 1.1-2.1) higher odds of utilizing other primary care providers, compared to uninjured players. Part 2: all GLM estimates were statistically non-significant, indicating that mean costs among players using health care did not differ between injured and uninjured players. Handball injuries during adolescence were associated with increased healthcare use, with gender and injury-type differences, informing youth sport injury prevention in Denmark.