Abstract
To investigate the incidence of the Sri Lankan pediatric population who seek emergency surgical services and who are subsequently at risk of impoverishment and catastrophic expenditure. Prospective data collection at a tertiary pediatric Sri Lankan hospital of direct out-of-pocket (OOP) medical and nonmedical expenses related to pediatric surgical interventions. Catastrophic expenditure and risk of impoverishment were respectively described as expenses superior to 10% of household income and falling below the impoverishment line due to income drop. PPP = purchasing power parity: I$ 3.65, I$ 2.15, and national poverty line (NPL). Distribution of income were estimated using a gamma distribution. Two hundred and twenty pediatric patient surveys completed by carers were collected. Two hundred had complete data for analysis. Ninety-six patients required emergency procedures; the others underwent elective surgeries. The overall direct medical and nonmedical expenses (total direct=TD) mean per patient was I$116.6 and the overall indirect expenses mean per patient was I$94.9. 53.2% were affected by catastrophic expense. 85% (n=170) of the study population was below the NPL. Receiving surgical care would impact up to 74.1% at the NPL threshold and up to 87.1% at the I$3.65 PPP/day limit. If pediatric surgery care is required, 25.9% of the Sri Lankan population is at risk of impoverishment or catastrophic expenditure. There is need for financial aid.
Published Version
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