Department of Global Public Health and Primary Care, University of Bergen, Norway; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Injury. 2022 Jan;53(1):23-29. doi: 10.1016/j.injury.2021.11.009. Epub 2021 Nov 8.
Road traffic injuries are among the most important causes of morbidity and mortality and cause substantial economic loss to households in Ethiopia. This study estimates the financial risks of seeking trauma care due to road traffic injuries in Addis Ababa, Ethiopia.
This is a cross-sectional survey on out-of-pocket (OOP) expenditures related to trauma care in three public and one private hospital in Addis Ababa from December 2018 to February 2019. Direct medical and non-medical costs (2018 USD) were collected from 452 trauma cases. Catastrophic health expenditures were defined as OOP health expenditures of 10% or more of total household expenditures. Additionally, we investigated the impoverishment effect of OOP expenditures using the international poverty line of $1.90 per day per person (adjusted for purchasing power parity).
Trauma care seeking after road traffic injuries generate catastrophic health expenditures for 67% of households and push 24% of households below the international poverty line. On average, the medical OOP expenditures per patient seeking care were $256 for outpatient visits and $690 for inpatient visits per road traffic injury. Patients paid more for trauma care in private hospitals, and OOP expenditures were six times higher in private than in public hospitals. Transport to facilities and caregiver costs were the two major cost drivers, amounting to $96 and $68 per patient, respectively.
Seeking trauma care after a road traffic injury poses a substantial financial threat to Ethiopian households due to lack of strong financial risk protection mechanisms. Ethiopia's government should enact multisectoral interventions for increasing the prevention of road traffic injuries and implement universal public finance of trauma care.
道路交通伤害是发病率和死亡率的最重要原因之一，给埃塞俄比亚家庭造成了巨大的经济损失。本研究旨在评估埃塞俄比亚亚的斯亚贝巴因道路交通伤害寻求创伤治疗的家庭所面临的财务风险。
这是一项横断面调查，于 2018 年 12 月至 2019 年 2 月在亚的斯亚贝巴的三家公立医院和一家私立医院进行，调查了与创伤治疗相关的自付（OOP）支出。共收集了 452 例创伤病例的直接医疗和非医疗费用（2018 年美元）。灾难性卫生支出被定义为家庭总支出的 10%或以上的卫生支出。此外，我们使用国际贫困线（每人每天 1.90 美元，按购买力平价调整）调查了 OOP 支出的贫困效应。
因道路交通伤害寻求创伤治疗的家庭中，有 67%的家庭发生灾难性卫生支出，24%的家庭陷入国际贫困线以下。平均而言，每例因道路交通伤害寻求治疗的患者的医疗 OOP 支出为门诊 256 美元，住院 690 美元。患者在私立医院支付的创伤护理费用更高，而私立医院的 OOP 支出比公立医院高 6 倍。到医疗机构的交通费用和护理人员费用是两个主要的费用驱动因素，分别为每位患者 96 美元和 68 美元。
由于缺乏强有力的财务风险保护机制，埃塞俄比亚家庭因道路交通伤害寻求创伤治疗而面临巨大的财务威胁。埃塞俄比亚政府应采取多部门干预措施，加强道路交通伤害预防，并实施创伤治疗的全民公共财政。
