Cost Analysis of Treatment of Road Traffic Injuries among Victims at the Kenyatta National Hospital Nairobi City County, Kenya

Abstract

Background; Many studies have reported Road traffic injuries (RTIs) leading to fatalities of over one million victims annually and negatively impacting on health, economy and development of the society as a whole, furthermore, young men and women at their most economic age group, are highly affected by RTIs and in most cases it causing mortality and very severe morbidity due disability. With projection by the year 2030, RTIs will be ranked as the fifth cause of disability adjusted life years (DALYs) lost. There is little or no any published Evidence on healthcare resource utilization and allocations after RTIs, especially in developing countries. Africa included. Locally in Kenya road accident remains a major public health concern, with high mortality and morbidity rates reported annually. Aim: The Main objective of this study was to analyze the total hospital Expenditure/cost related to RTI (Road traffic injury) admitted at the Kenyatta National Hospital for a period of 3 months from the start of the study. Methods: This was a cross sectional study design; the study location was the Kenyatta National Hospital Nairobi, surgical wards and Accident & Emergency. A sample (n=124) comprising of victims admitted to the Hospital due to RTI from January 25th 2019 to 30 th May 2019. Systematic sampling was used. The independent variable was the cost of treatment while the dependent variable was direct medical treatment cost, non-medical treatment cost, productivity loss and length of stay. Primary Data collections was done through interviews of all victims admitted at the KNH through A&E and qualify as per the inclusion criteria, the victims were admitted at the surgical unit level 4,5, and 6. The data collection of direct and direct non-medical cost, was by data extraction tool, testing of the tools was done at the surgical ward. Productivity loss of the victims was calculated by use of Work Productivity and Activity Impairment Questionnaire (WPAIQ). Data was analyzed by SSPS version 22. Results: From the study 76.6% of the road users were male, while female was 23.4%. Most of injuries were lower limbs, head and upper limbs in that order. Leading injuries by mode of transport was Motorcycle at 43.5%, pedestrian and public transport at 23.4 % and 17.7%. Daily bed charges and Surgery were the leading cost component followed by pharmacy. Average length of stay was 24.1 days, average medical cost was at (KSH 66,482, 642 USD), productivity loss at (KSH19, 061, USD 184) and indirect cost at KSH10, 745 USD 107). There was significance correlation between total bed charges, medical cost and productivity loss at P=0.01. (Cl 95%) chi square showed linear by linear association of P value of .000 Conclusion: Road traffic accident is an economic burden to individual, family and country at large, males more affected at their most economic age groups. Findings will aid policy makers in review on resource allocation. Further Motion studies on cost analysis of RTIs, over a longer period to be conducted to provide more insight on the subject.