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The Economic and Social Burden of Traumatic Injuries: Evidence from a Trauma Hospital in Port-au-Prince, Haiti

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Abstract

Introduction

The cost of traumatic injury is unknown in Haiti. This study aims to examine the burden of traumatic injury of patients treated and evaluated at a trauma hospital in the capital city of Port-au-Prince.

Methods

A retrospective cross-sectional chart review study was conducted at the Hospital Bernard Mevs Project Medishare for all patients evaluated for traumatic injury from December 2015 to January 2016, as described elsewhere (Zuraik and Sampalis in World J Surg, https://doi.org/10.1007/s00268-017-4088-2, 2017). Direct medical costs were obtained from patient hospital bills. Indirect and intangible costs were calculated using the human capital approach.

Results

A total of 410 patients were evaluated for traumatic injury during the study period. Total costs for all patients were $501,706 with a mean cost of $1224. Indirect costs represented 63% of all costs, direct medical costs 19%, and intangible costs 18%. Surgical costs accounted for the majority of direct medical costs (29%). Patients involved in road traffic accidents accounted for the largest number of injuries (41%) and the largest percentage of total costs (51%). Patients with gunshot wounds had the highest total mean costs ($1566). Mean costs by injury severity ranged from $62 for minor injuries, $1269 for serious injuries, to $13,675 for critical injuries.

Conclusion

Injuries lead to a significant economic burden for individuals treated at a semi-private trauma hospital in the capital city of Port-au-Prince, Haiti. Programs aimed at reducing injuries, particularly road traffic accidents, would likely reduce the economic burden to the nation.

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References

  1. Sakran JV, Greer SE, Werlin E et al (2012) Care of the injured worldwide: trauma still the neglected disease of modern society. Scand J Trauma Resusc Emerg Med 20:64

    Article  PubMed  PubMed Central  Google Scholar 

  2. de Ramirez SS, Hyder AA, Herbert HK et al (2012) Unintentional injuries: magnitude, prevention, and control. Annu Rev Public Health 33:175–191

    Article  PubMed  Google Scholar 

  3. Chandran A, Hyder AA, Peek-Asa C (2010) The global burden of unintentional injuries and an agenda for progress. Epidemiol Rev 32:110–120

    Article  PubMed  PubMed Central  Google Scholar 

  4. Wesson HK, 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 and plan 29(6):795–808

    Article  Google Scholar 

  5. World Health Organization (2008) The global burden of disease: 2004 update 2008. Department of Health Statistics and Informatics, Geneva

    Google Scholar 

  6. World Health Organization (2010) Injuries and violence: the facts. World Health Organization, Geneva

    Google Scholar 

  7. Mock CN, Gloyd S, Adjei S et al (2003) Economic consequences of injury and resulting family coping strategies in Ghana. Accid Anal Prev 35(1):81–90

    Article  PubMed  Google Scholar 

  8. Debas HT, Gosselin RA, McCord C et al (2006) In: Jamison D, Evans D, Alleyne G, Jha P, Breman J, Measham A (eds) Disease control priorities in developing countries, 2nd edn. Oxford University Press, New York

    Google Scholar 

  9. Lopez AD, Mathers CD, Ezzati M et al (2006) Global burden of disease and risk factors. The World Bank and Oxford University Press, New York

    Book  Google Scholar 

  10. Gosselin RA, Spiegel DA, Coughlin R et al (2009) Injuries: the neglected burden in developing countries. Bull World Health Organ 87(4):246a

    Article  Google Scholar 

  11. Nilsen P, Hudson D, Lindqvist K (2006) Economic analysis of injury prevention-applying results and methodologies from cost-of-injury studies. Int J Inj Control Saf Promot 13(1):7–13

    Article  Google Scholar 

  12. World Health Organization. Choosing interventions that are Cost Effective (WHO-CHOICE). Geneva, Switzerland. Web site: http://who.int/choice/en/. Accessed 21 October 2016

  13. Jamison DT, Breman JG, Measham AR et al (2006) Disease control priorities in developing countries, 2nd edn. The World Bank and Oxford University Press, Washington

    Google Scholar 

  14. Gyllensvard H (2010) Cost-effectiveness of injury prevention–a systematic review of municipality based interventions. Cost Eff Resour Alloc 8:17

    Article  PubMed  PubMed Central  Google Scholar 

  15. Waters HR, Hyder AA, Phillips TL (2004) Economic evaluation of interventions to reduce road traffic injuries-a review of the literature with applications to low and middle-income countries. Asia Pac J Public Health 16(1):23–31

    Article  CAS  PubMed  Google Scholar 

  16. Scuffham PA (2008) Cost-effectiveness analyses for injury prevention initiatives in low- and middle-income countries. Inj Prev 14(4):217–219

    Article  PubMed  Google Scholar 

  17. Dewberry L, McCullough C, Goss J et al (2014) Trauma capacity in the central plateau department of Haiti. J Surg Res 192(1):34–40

    Article  PubMed  Google Scholar 

  18. Aluisio AR, Gore R, Decome I et al (2014) Prehospital characteristics in the North East department of Haiti: a cross-sectional study from a low-income setting without prehospital systems. Prehospital Disaster Med 29(3):230–236

    Article  PubMed  Google Scholar 

  19. Rouhani SA, Eliacin HC, Edmond MC et al (2015) 214 Traumatic injuries at an emergency department in central Haiti. Ann Emerg Med 66:S79

    Article  Google Scholar 

  20. Marsh RH, Rouhani SA, Pierre P et al (2015) Strengthening emergency care: experience in central Haiti. Lancet Glob Health 3(Suppl 2):S5–S7

    Article  PubMed  Google Scholar 

  21. Aluisio AR, De Wulf A, Louis A et al (2015) Epidemiology of Traumatic injuries in the Northeast region of Haiti: a cross-sectional study. Prehospital Disaster Med 30(6):599–605

    Article  PubMed  Google Scholar 

  22. McCullough C, DeGennaro V Jr, Bagley JK et al (2016) A national trauma capacity assessment of Haiti. J Surg Res 201(1):126–133

    Article  PubMed  Google Scholar 

  23. Zuraik C, Sampalis JS (2017) Epidemiology of traumatic injuries at an urban hospital in Port-au-Prince, Haiti. World J Surg. https://doi.org/10.1007/s00268-017-4088-2

    Google Scholar 

  24. The World Bank (2015) Life expectancy at birth, total (years). Web site: http://data.worldbank.org/indicator/SP.DYN.LE00.IN?locations=HT. Accessed 10 January 2016

  25. Haiti Libre (2016) Full details on minimum wage. Web site: http://www.haitilibre.com/en/news-17541-haiti-flash-full-details-on-the-new-minimum-wage.html. Accessed 10 January 2016

  26. The World Bank (2015) GDP per capita (current US$). Web site: http://data.worldbank.org/indicator/NY.GDP.PCAP.CD?locations=HT. Accessed 10 January 2016

  27. The World Bank (2015) GDP growth (annual %). Web site: http://data.worldbank.org/indicator/NY.GDP.MKTP.KD.ZG?locations=HT. Accessed 10 January 2016

  28. Haiti Libre (2016) GDP of 2.2% target of Haitian Government. Web site: http://www.haitilibre.com/en/news-19570-haiti-economy-just-1-growth-for-haiti-in-2017.html. Accessed 12 January 2016

  29. Asian Development Bank (2003) Road safety guidelines for the Asia and Pacific region. Web site: https://www.adb.org/sites/default/files/publication/29532/road-safety-guidelines.pdf

  30. McMahon K, Dahdah S (2008) The true cost of road crashes: valuing life and the cost of a serious injury. Int Road Assess Programm. Web site: http://www.scirp.org/(S(351jmbntvnsjt1aadkposzje))/reference/ReferencesPapers.aspx?ReferenceID=1722067

  31. Anh TT, Anh TT, Dao NX (2005) The cost of road traffic accident in Vietnam. Proc East Asia Soc Transp Stud 5:1923–1933

    Google Scholar 

  32. Rezaei S, Arab M, Matin BK et al (2014) Extent, consequences and economic burden of road traffic crashes in Iran. J Inj Violence Res 6(2):57–63

    Article  PubMed  PubMed Central  Google Scholar 

  33. Center for Disease Control and Prevention (2012) Years of potential life lost. Web site: http://www.cdc.gov/ophss/csels/dsepd/ss1978/lesson3/section3.html. Accessed 1 June 2016

  34. Thanh NX, Hang HM, Chuc NT et al (2003) The economic burden of unintentional injuries: a community-based cost analysis in Bavi, Vietnam. Scand J Public Health 62:45–51

    Article  Google Scholar 

  35. Li ZH, Zhao ZT, Guo YX et al (2005) The burden caused by injury in countryside residents in Dongyang, Shandong Province. Chin J Prev Med 39:273–276

    Google Scholar 

  36. Nguyen H, Ivers R, Jan S et al (2012) Catastrophic household costs due to injury in Vietnam. J Inj 44(5):684–690

    Article  Google Scholar 

  37. Joshi SK, Shrestha S (2009) Economic and social burden due to injuries and violence in Nepal: a cross-sectional study. Kathmandu Univ Med J 7:344–350

    CAS  Google Scholar 

  38. McDonald A, Duncan ND, Mitchell DI et al (1999) Trauma aetiology and cost in the accident and emergency unit of the University Hospital of the West Indies. West Indian Med J 48:141–142

    CAS  PubMed  Google Scholar 

  39. Gurses D, Sarioglu-Buke A, Baskan M et al (2003) Cost factors in pediatric trauma. Can J Surg 46:441–445

    PubMed  PubMed Central  Google Scholar 

  40. Zhao J, Huang C, Liu M et al (2002) The analysis of medical-related cost for in-patients with injuries in Nigxia region. Chin J Prev Med 36:374–377

    Google Scholar 

  41. Melione LP, Mello-Jorge MH (2008) Unified national health system costs in Sao Jose dos Campos, Sao Paulo State, Brazil, for hospital admissions due to external causes. Cadernos de Saude Publica 24:1814–1824

    Article  PubMed  Google Scholar 

  42. Plummer JM, Brown H, Jones K et al (2010) Trauma: the burden of a preventable problem. West Indian Med J 59:26–28

    CAS  PubMed  Google Scholar 

  43. Kaya E, Ozguc H, Tokyay R et al (1999) Financial burden of trauma care on a university hospital in a developing country. J Trauma 47:738–745

    Article  Google Scholar 

  44. Chahal HS, Fort NS, Bero L (2013) Availability, prices and affordability of essential medicines in Haiti. J Glob Health 3(2):020405

    Article  PubMed  PubMed Central  Google Scholar 

  45. Allard D, Burch VC (2005) The cost of treating serious abdominal firearm-related injuries in South Africa. South Afr Med J 95:591–594

    CAS  Google Scholar 

Download references

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Correspondence to John Sampalis.

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Zuraik, C., Sampalis, J. & Brierre, A. The Economic and Social Burden of Traumatic Injuries: Evidence from a Trauma Hospital in Port-au-Prince, Haiti. World J Surg 42, 1639–1646 (2018). https://doi.org/10.1007/s00268-017-4360-5

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  • DOI: https://doi.org/10.1007/s00268-017-4360-5

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