Abstract
There is little documentation of the potential catastrophic effects of injuries on families due to out of pocket (OOP) expenditure for medical care. Patients who were admitted for at least one night in a tertiary care hospital of Chandigarh city due to injury were recruited and were followed-up at 1, 2 and 12 months after discharge to collect information on OOP expenditure. Out of the total 227 patients, 60% (137/227) had sustained road traffic injuries (RTI). The average OOP expenditure per hospitalisation and up to 12 months post discharge was USD 388 (95% CI: 332–441) and USD 1046 (95% CI: 871–1221) respectively. Mean OOP expenditure for RTI and non-RTI cases during hospitalisation was USD 400 (95% CI: 344–456) and USD 369 (95% CI: 313–425) respectively. The prevalence of catastrophic expenditure was 30%, and was significantly higher among those belonging to the lowest income quartile (OR-26.50, 95% CI: 6.70–105.07, p-value: <0.01) and with an inpatient stay greater than 7 days (OR-10.60, 95% CI: 4.21–26.64, p-value: <0.01). High OOP expenditure for treatment of injury puts a significant economic burden on families. Measures aimed at increasing public health spending for prevention of injury and providing financial risk protection are urgently required in India.
Highlights
5.1 million people per year have been reported to die due to injury, accounting for around 9.2% of global mortality [1]
The present study was undertaken in Postgraduate Institute of Medical Education and Research (PGIMER), a tertiary care institution for provision of speciality services, medical education and research located in Chandigarh, India
We found no significant difference in the out of pocket (OOP) expenditures, catastrophic health expenditures or coping mechanisms on comparing data collected by two interview methods
Summary
5.1 million people per year have been reported to die due to injury, accounting for around 9.2% of global mortality [1]. The magnitude and burden of injuries and violence are more devastating in developing economies, with more than 57% of the injury burden concentrated in low and middle income countries (LMICs) [1]. Among LMICs mortality due to road injuries has been projected to rise by 60% from 2015 to 2030, falls by 43% and self-inflicted injuries by 23% [1]. Injuries are the second most common cause of death after 5 years of age in India [2]. As per the National Crime Records Bureau (NCRB) report, there was a 51.8% increase in unintentional injury deaths and a 23% increase in suicidal deaths from year 2002 to 2013 [3]. From an economic viewpoint, injuries are the leading cause of death in the economically productive age group of
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