Abstract
Purpose
To determine the cost of surgically treated mandibular fractures, methods of payments, and the relationship between socioeconomic status of subjects and payment methods in a Nigerian tertiary hospital.
Methods
A retrospective review of 100 subjects who sustained 148 isolated mandibular fractures was conducted between November 2014 and October 2019. Demographics, socioeconomic status, mechanism of injury, fracture sites, type of treatment, and cost of treatment with methods of payments were obtained from medical records and hospital billing sheets of eligible subjects. The relationship between independent variables (age, sex, payment method, and treatment methods) and dependent variable (income class) was analyzed.
Results
The mean age of the subjects was 31.8 ± 10.9 years; age range 17–63 years. The majority (75/100) belonged to the middle-income class. The costs of mandibular fractures repairs were ₦42,900 ($119.17) and ₦132,500 ($386.05) for closed reduction (CRMMF) and open reduction and rigid internal fixation (ORIF) respectively. All subjects in the low-income class (4/100) paid out of pocket for their treatment compared with 93% and 62% of the middle- and high-income classes respectively (p = 0.001). Half of the subjects in the low-income class had ORIF compared with 31% and 62% of the middle- and high-income classes respectively.
Conclusions
The treatments costs of mandibular fractures were ₦42,900 ($119.17) and ₦132,500 ($386.05) for CRMMF and ORIF respectively. The treatment costs were mostly out-of-pocket expenditure meaning that the subjects in the low-and middle-income classes bore the financial burden of their injuries.
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Data availability
Data supporting the conclusions of this study are included in the article. The dataset of this study is available on reasonable request from the corresponding author.
References
Wesson HKH, Boikhutso N, Bachani AM et al (2014) The cost of injury and trauma care in low and middle-income countries: a review of economic evidence. Health Policy Plan 29:795–808
Aladelusi T, Akinmoladun V, Olusanya A et al (2014) Analysis of road traffic crashes–related maxillofacial injuries ceverity and Concomitant injuries in 201 patients seen at the UCH, Ibadan. Craniomaxillofac Trauma Reconstr 7:284–289
Oginni FO, Oladejo T, Alake DP et al (2016) Facial bone fractures in Ile-Iffe, Nigeria: an update on pattern of presentation and care. J Maxillofac Oral Surg 15:184–190
Tugaineyo EI, Odhiambo WA, Akama MA, Guthua SW, Dimba EAO (2012) Aetiology, pattern and management of oral and maxillofacial injuries at Mulago National Referral Hospital. East Afr Med J 89:351–358
Teshome A, Andualem G, Tsegie R, Seifu S (2017) Two years retrospective study of maxillofacial trauma at a tertiary center in North West Ethiopia. BMC Res Notes 10:373
Lalloo R, Lucchesi LR, Bisignano C, et al (2020) Epidemiology of facial fractures: incidence, prevalence and years lived with disability estimates from the Global Burden of Disease 2017 study [published online ahead of print, 2020 Jan 8]. Inj Prev; injuryprev-2019–043297. https://doi.org/10.1136/injuryprev-2019-043297
Braimah RO, Ukpong DI, Ndukwe KC, et al (2017) Comparative study of anxiety and depression following maxillofacial and orthopedic injuries. Study from a Nigerian University Teaching Hospital. Clin Exp Dent Res 3 215–9.
Saperi BS, Ramli R, Ahmed Z et al (2017) Cost analysis of facial injury treatment in two university hospitals in Malaysia: a prospective study. Clinicoecon Outcomes Res 9:107–113
VandeGriend ZP, Hashemi A, Shkoukani M (2015) Changing trends in adult facial trauma epidemiology. J Craniofac Surg 26:108–112
Dillon JK, Christensen B, McDonald T et al (2012) The financial burden of mandibular trauma. J Oral Maxillofac Surg 70:2124–2134
Pena I, Roberts LE, Guy WM et al (2014) The cost and inpatient burden of treating mandible fractures: a nationwide inpatient sample database analysis. Otolaryngol Head Neck Surg 151:591–598. https://doi.org/10.1177/0194599814542590
Adesina AD, Ogaji DS (2020) Out-of-pocket payment for healthcare and implications for households: situational analysis in Yenagoa, Bayelsa State. J Community Med Primary Health Care 32:1–16
Chukwuonye II, Chuku A, Okpechi IG et al (2013) Socioeconomic status and obesity in Abia State, South East Nigeria. Diabetes Metab Syndr Obes 6:371–378
Shetty V, Atchison K, Der-Matirosian C, Wang J, Belin TR (2007) The mandible injury severity score: development and validity. J Oral Maxillofac Surg 65:663–670
Chrcanovic BR, Abreu MH, Freire-Maia B et al (2012) 1,454 mandibular fractures: a 3-year study in a hospital in Belo Horizonte, Brazil. J Craniomaxillofac Surg 40:116–123
Perry M, Brown A, Banks P (2015) Fractures of facial skeleton. Elsevier, United Kingdom, pp 69–140
Schmidt BL, Kearns G, Gordon N et al (2000) A financial analysis of maxillomandibular fixation versus rigid internal fixation for treatment of mandibular fractures. J Oral Maxillofac Surg 58:1206–1210
Moncrieff NJ, Qureshi C, Deva AK (2004) A comparative cost analysis of maxillofacial trauma in Australia. J Craniofac Surg 15:686–691
Akhiwu BI, Suleiman HH, Muktar M et al (2015) Cost of illness in patients with mandibular fracture following road traffic crash and its socioeconomic implications in Kano State, Nigeria. J West Afr Coll Surg 5:1–16
Uzochukwu B, Ughasoro MD, Etiaba E et al (2015) Health care financing in Nigeria: implications for achieving universal health coverage. Niger J Clin Pract 18:437–444
Ofoli JNT, Ashau-Oladipo T, Hati SS et al (2020) Preventive healthcare uptake in private hospitals in Nigeria: a cross-sectional survey (Nisa premier hospital). BMC Health Serv Res 20:273
Wang Q, Fu AZ, Brenner S et al (2015) Out-of-pocket expenditure on chronic non-communicable diseases in sub-Saharan Africa: the case of rural Malawi. PLoS one 10(1):e0116897
Gupta I, Chowdhury S, Prinja S et al (2016) Out-of-pocket spending on out-patient care in India: assessment and options based on results from a district level survey. PLoS one 11(11):e0166775
Correa-Burrows P (2012) Out-of-pocket health care spending by the chronically ill in Chile. Procedia Econ Financ 1:88–97
Etiaba E, Onwujekwe O, Uzochukwu B et al (2015) Investigating payment coping mechanisms used for the treatment of uncomplicated malaria to different socio-economic groups in Nigeria. Afr Health Sci 15:42–48
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BAF and SBA contributed to the conception and design of the study. BAF and TAA contributed to the acquisition of data. BAF, OTA, and TAA conducted the costs and statistical analyses and drafted the manuscript. All authors reviewed the manuscript and approved it for publication.
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The study was approved (IRB/IEC/0004553) by the Ethics and Research Committee of Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria.
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Not applicable (retrospective study with no patient contacts).
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The authors declare no competing interests.
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Famurewa, B.A., Aregbesola, S.B., Alade, O.T. et al. Treatment costs of mandibular fractures in a Nigerian hospital. Oral Maxillofac Surg 26, 417–422 (2022). https://doi.org/10.1007/s10006-021-01000-7
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DOI: https://doi.org/10.1007/s10006-021-01000-7