School of Pharmacy, University of Reading, Reading, United Kingdom.
Toxiven Biotech Private Limited, Coimbatore, Tamil Nadu, India.
PLoS Negl Trop Dis. 2023 Oct 16;17(10):e0011699. doi: 10.1371/journal.pntd.0011699. eCollection 2023 Oct.
India suffers ~58,000 annual deaths due to snakebites. The 'Big Four' snakes (Russell's viper, Indian cobra, common krait, and saw-scaled viper) that are responsible for most bites cause diverse clinical effects. Delayed treatment increases the risk of serious complications and treatment costs. Although government hospitals offer free treatment for snakebites in India, most patients opt for private healthcare, which is an out-of-pocket expense as they often lack health insurance coverage. This study aims to analyse snakebite treatment costs in private tertiary care hospitals in Tamil Nadu, India and identifies the key factors contributing to treatment costs.
METHODOLOGY/PRINCIPAL FINDINGS: The treatment cost details for 913 snakebite victims were collected from 10 private tertiary care hospitals across Tamil Nadu. The data were classified into hospital, pharmacy, investigation, and laboratory costs, and analysed to determine various factors that contribute to the costs. The results demonstrate that the average treatment costs vary widely for different snakes. The hospital and pharmacy costs are higher than investigation and laboratory costs for all snakebites. Notably, Russell's viper bites cost significantly more than the bites from other snakes. Overall, the type of snake, nature of complications, specialist treatments required, and arrival time to hospitals were identified as some of the key factors for higher treatment costs.
CONCLUSIONS/SIGNIFICANCE: These data demonstrate that 80% of snakebite patients can be treated with INR 100,000 (GBP 1000 or USD 1200) or less. This study emphasises the urgent need to improve rural medical care by providing appropriate training for healthcare professionals and essential resources to facilitate early assessment of patients, administer the initial dose of antivenom and refer the patients to tertiary care only when needed. Moreover, the outcome of this study forms a basis for developing appropriate policies to regulate snakebite treatment costs and provide affordable medical insurance for vulnerable communities.
印度每年约有 58000 人因蛇伤而死亡。“四大毒蛇”（印度眼镜蛇、圆斑蝰、印度环蛇和锯鳞蝰）是造成大多数咬伤的元凶，它们会引起不同的临床症状。延迟治疗会增加出现严重并发症和治疗费用的风险。虽然印度政府医院为蛇伤患者提供免费治疗，但大多数患者选择私人医疗保健，因为他们往往缺乏医疗保险，这是一种自掏腰包的费用。本研究旨在分析印度泰米尔纳德邦私立三级护理医院的蛇伤治疗费用，并确定导致治疗费用的关键因素。
方法/主要发现：从泰米尔纳德邦的 10 家私立三级护理医院收集了 913 名蛇伤患者的治疗费用详细信息。将数据分为医院、药房、检查和实验室费用，并进行分析以确定导致费用的各种因素。结果表明，不同蛇类的平均治疗费用差异很大。所有蛇伤的医院和药房费用都高于检查和实验室费用。值得注意的是，印度眼镜蛇咬伤的费用明显高于其他蛇类咬伤。总的来说，蛇的种类、并发症的性质、所需的专科治疗以及到达医院的时间被确定为导致治疗费用较高的一些关键因素。
结论/意义：这些数据表明，约 80%的蛇伤患者可以用 INR 100000（~GBP 1000 或 USD 1200）或更少的费用进行治疗。本研究强调了通过为医疗保健专业人员提供适当的培训和基本资源，以促进对患者的早期评估、给予初始剂量的抗蛇毒血清以及仅在必要时将患者转至三级护理，来改善农村医疗保健的迫切需要。此外，本研究的结果为制定适当的政策提供了依据，以规范蛇伤治疗费用，并为弱势社区提供负担得起的医疗保险。
