Abstract
Seafarers sail the high seas around the globe. In case of illness, they are protected by international regulations stating that the employers must pay all expenses in relation to repatriation, but very little is known about the cost of these repatriations. The objective of this study was to estimate the financial burden of repatriations in case of illness. We applied a local approach, a micro-costing method, with an employer perspective using four case vignettes: I) Acute myocardial infarction (AMI), II) Malignant hypertension, III) Appendicitis and IV) Malaria. Direct cost data were derived from the Danish Maritime Authority while for indirect costs estimations were applied using the friction cost approach. The average total costs of repatriation varied for the four case vignettes; AMI (98,823 EUR), Malignant hypertension (47,597 EUR), Appendicitis (58,639 EUR) and Malaria (23,792 EUR) mainly due to large variations in the average direct costs which ranged between 9560 euro in the malaria case and 77,255 in the AMI case. Repatriating an ill seafarer is a costly operation and employers have a financial interest in promoting the health of seafarers by introducing or further strengthen cost-effective prevention programs and hereby reducing the number of repatriations.
Highlights
Seafarers are an essential workforce to the global economy with around 1.5 million people working day and night [1], securing transportation of more than 90% of the goods across the globe [2, 3]
The average total costs of the four case vignettes varied between 23,792 euro for the least expensive – the malaria case vignette – up to 98,823 for the most expensive – the Acute myocardial infarction (AMI) case vignette
: Case vignette no. 1 The AMI case vignette was comprised of a male seafarer who was evacuated by helicopter to the port of Bergen, Norway in 2011
Summary
Seafarers are an essential workforce to the global economy with around 1.5 million people working day and night [1], securing transportation of more than 90% of the goods across the globe [2, 3]. The remote character of their working environment defines them as a hard to reach population group [4,5,6] This vulnerability of seafarers makes their health and wellbeing a concern and priority in a public health point of view. Direct and Faurby et al Health Economics Review (2017) 7:46 illnesses and what the major cost drivers are, when seafarers are repatriated [15]. This type of study will provide value to maritime stakeholders and decision makers [16] and eventually enable employers to implement cost effective preventive measures and better integrated care and thereby save money
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