Economic Burden of Head Injury Patients Attending a Tertiary Level Hospital in a Developing Country Like Bangladesh

Akm Jakirul Alam, Asifur Rahman, M. M. Haque, A. Hossain, Z. Islam
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Abstract

Objective: Objective of the study was to estimate the economic burden of head injury (HI) patients attending a tertiary level hospital. This study also tried to determine the socio-demographic characteristics, to estimate direct and indirect cost incurred by the head injury patients and to assess economic burden by different types of accidents causing head injury. Methods:The study was a cross-sectional descriptive study carried out to estimate the economic burden of head injury patients attending a tertiary level hospital during the period from January to June 2010, conducted at the neurosurgery department of Dhaka Medical College Hospital (DMCH). All the conscious head injury patients of both sexes, treated in Neurosurgery department of DMCH, willing to participate in the study were included in the study. Convenience type of non-probability sampling technique was followed and sample size of this study was 110. Face to face interview was conducted with the patient and / or attendant for data collection and specific pre-designed semi-structured and pre-tested questionnaire was used for the interview session. After Categorizing, coding, cleaning and summarizing, all data were analyzed by the software SPSS windows program version 12.0. Result: More than half (53.6%) of the patients of this study, were in younger age group (21 to 30 years) with mean (±SD) age of 29.1(±8.36) years. Majority of the patients (69.0%) were males, Average monthly family income of the patients was Tk.14,509.09 (±5762.49). Majority (36.4%) of the patients had primary level education while 20.9% were housewives. Major incidences of different types of accidents included road traffic accident (63.6%), assault (20.0%), industrial accident (8.0%) and fall from height (8.0%). Average length of the stay of the patients in the hospital was 7.43 (±3.64) days. In respect of direct cost, average travel cost incurred by the patients was Tk.3,628.18 (±2055.56), average drug cost was Tk.1,618 (±801.51), average laboratory investigation cost was Tk.2390 (±626.47) and average cost of food was Tk.2235.45 (±1208.19). Average direct treatment cost incurred by the patients was Tk.9590.10 (±4041.13). The average duration of absent from work place was 7.07 (±3.316) days and most of the patients average daily income (self) was Tk.340.65 (±158.97). Average loss of income due to illness was Tk.2415.32(±1623.68) and average cost behind giving tips to hospital staff by the patients was Tk.221.50 (±78.34). The average indirect cost of these study patients was Tk.2001.72 (±1869.27). Overall, average treatment cost incurred by the patients was Tk.12,008.05 (±5051.95). Majority (38.0%) had a cost from Tk10001 to Tk.15000. Conclusion: The study finding can help policy makers, public health specialists, future researchers and enthusiastic individuals to formulate specific strategies for reduction of economic burden of head injury patients by providing cost-effective health care services throughout the country. Bangladesh Journal of Neuroscience 2014; Vol. 30 (2): 104-111
孟加拉国等发展中国家三级医院颅脑损伤患者的经济负担
目的:本研究的目的是评估三级医院颅脑损伤(HI)患者的经济负担。本研究还试图确定脑损伤患者的社会人口学特征,估计脑损伤患者的直接和间接成本,并评估不同类型的脑损伤事故造成的经济负担。方法:采用横断面描述性研究,评估2010年1 - 6月在达卡医学院附属医院神经外科就诊的三级医院颅脑损伤患者的经济负担。所有愿意参与研究的DMCH神经外科收治的有意识颅脑损伤患者,不论男女。本研究采用便利型非概率抽样技术,样本量为110人。与患者和/或护理人员进行面对面访谈以收集数据,并使用预先设计的特定半结构化和预先测试的问卷进行访谈。所有数据经过分类、编码、清理、汇总后,采用SPSS windows程序12.0进行分析。结果:超过一半(53.6%)的患者年龄在21 ~ 30岁之间,平均(±SD)年龄为29.1(±8.36)岁。患者以男性居多(69.0%),家庭月平均收入为14509.09克朗(±5762.49)。大多数患者(36.4%)为小学文化程度,20.9%为家庭主妇。不同类别意外的主要发生率包括道路交通意外(63.6%)、殴打(20.0%)、工业意外(8.0%)及高空坠落(8.0%)。患者平均住院时间为7.43(±3.64)d。直接费用方面,患者平均差旅费为3,628.18(±2055.56)元,平均药费为1,618(±801.51)元,平均实验室调查费用为2390(±626.47)元,平均食品费用为2235.45(±1208.19)元。患者直接治疗费用平均为Tk.9590.10(±4041.13)。平均缺勤时间为7.07(±3.316)天,大部分患者平均日收入(自我)为340.65(±158.97)。患者因病造成的平均收入损失为2415.32元(±1623.68元),患者向医院工作人员提供小费的平均费用为221.50元(±78.34元)。这些研究患者的平均间接费用为Tk.2001.72(±1869.27)。总体而言,患者的平均治疗费用为12,008.05元(±5051.95元)。大多数(38.0%)的成本从10001泰铢到15000泰铢。结论:研究结果可帮助决策者、公共卫生专家、未来的研究人员和热心的个人制定具体的策略,通过提供具有成本效益的卫生保健服务来减轻头部损伤患者的经济负担。孟加拉国神经科学杂志2014;Vol. 30 (2): 104-111
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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