Household Costs of Injuries: A Case Study of the Casualty and Accident Centre of Korle-Bu Teaching Hospital

Abstract

BACKGROUND: Accidents, and casualties in general remain a major cause of morbidity and mortality worldwide. There seems to be changing trends in causes of death over the past Century with gradual increasing importance of injuries in particular. It has been suggested that injury is one of the leading causes of death in many developing countries, accounting for more deaths than HIV, tuberculosis, and malaria combined. While the World Health Organization (WHO), lists road injury as the tenth commonest cause of death after ischaemic heart disease, stroke, lower respiratory infections, chronic obstructive pulmonary disease, respiratory system cancers, diabetes mellitus, Alzheimer’s disease, diarrhoeal diseases and tuberculosis worldwide, the use of cost estimates for evidence-based advocacy on injury prevention policies and strategies is crucial. OBJECTIVE: To determine the economic burden to patients with injuries at the Casualty and Accident centre of Korle-Bu Teaching Hospital METHODS: A cross-sectional study of patients at the Casualty and Accident centre of the Korle-Bu teaching hospital was undertaken. Using a sample size of 264, the direct cost was estimated. Indirect cost estimates were determined by use of the Human Capita approach to determine the burden of injuries. Intangible cost was assessed with a descriptive approach by use of a Likert scale. The overall cost was then reported, estimated by the summation of the total direct cost and total indirect cost. RESULTS: This study found the total direct and indirect costs to the respondents to be GHS 1,384,548.83 (US$ 318,287) and GHS 306,728.03 (US$ 70,512.19) respectively, representing 82% and 18% of the total cost of treatment. The estimated annual cost to all injured patients reporting to the unit was GHS 48,729,294.01 (US$ 11,202,136.55), with an average total cost of GHS 5,551.27 (US$ 1,276.15). The study also found that the highest proportion of injured patients experienced a moderate levels of intangible cost while a 32% experienced a high level of intangible cost. CONCLUSION: In addition to ongoing efforts in prevention, this study provides further evidence on the social limitations in protecting patients and their family from the high costs of severe injuries.