Skip to main content
Top
Published in: World Journal of Surgery 6/2018

01-06-2018 | Original Scientific Report

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

Authors: Christopher Zuraik, John Sampalis, Alexa Brierre

Published in: World Journal of Surgery | Issue 6/2018

Login to get access

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.
Literature
1.
go back to reference 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 20:64CrossRefPubMedPubMedCentral 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 20:64CrossRefPubMedPubMedCentral
2.
go back to reference de Ramirez SS, Hyder AA, Herbert HK et al (2012) Unintentional injuries: magnitude, prevention, and control. Annu Rev Public Health 33:175–191CrossRefPubMed de Ramirez SS, Hyder AA, Herbert HK et al (2012) Unintentional injuries: magnitude, prevention, and control. Annu Rev Public Health 33:175–191CrossRefPubMed
4.
go back to reference 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):795–808CrossRef 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):795–808CrossRef
5.
go back to reference World Health Organization (2008) The global burden of disease: 2004 update 2008. Department of Health Statistics and Informatics, Geneva World Health Organization (2008) The global burden of disease: 2004 update 2008. Department of Health Statistics and Informatics, Geneva
6.
go back to reference World Health Organization (2010) Injuries and violence: the facts. World Health Organization, Geneva World Health Organization (2010) Injuries and violence: the facts. World Health Organization, Geneva
7.
go back to reference 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):81–90CrossRefPubMed 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):81–90CrossRefPubMed
8.
go back to reference 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 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
9.
go back to reference Lopez AD, Mathers CD, Ezzati M et al (2006) Global burden of disease and risk factors. The World Bank and Oxford University Press, New YorkCrossRef Lopez AD, Mathers CD, Ezzati M et al (2006) Global burden of disease and risk factors. The World Bank and Oxford University Press, New YorkCrossRef
10.
go back to reference Gosselin RA, Spiegel DA, Coughlin R et al (2009) Injuries: the neglected burden in developing countries. Bull World Health Organ 87(4):246aCrossRef Gosselin RA, Spiegel DA, Coughlin R et al (2009) Injuries: the neglected burden in developing countries. Bull World Health Organ 87(4):246aCrossRef
11.
go back to reference 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):7–13CrossRef 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):7–13CrossRef
13.
go back to reference 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 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
14.
15.
go back to reference 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):23–31CrossRefPubMed 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):23–31CrossRefPubMed
16.
go back to reference Scuffham PA (2008) Cost-effectiveness analyses for injury prevention initiatives in low- and middle-income countries. Inj Prev 14(4):217–219CrossRefPubMed Scuffham PA (2008) Cost-effectiveness analyses for injury prevention initiatives in low- and middle-income countries. Inj Prev 14(4):217–219CrossRefPubMed
17.
go back to reference Dewberry L, McCullough C, Goss J et al (2014) Trauma capacity in the central plateau department of Haiti. J Surg Res 192(1):34–40CrossRefPubMed Dewberry L, McCullough C, Goss J et al (2014) Trauma capacity in the central plateau department of Haiti. J Surg Res 192(1):34–40CrossRefPubMed
18.
go back to reference 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):230–236CrossRefPubMed 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):230–236CrossRefPubMed
19.
go back to reference Rouhani SA, Eliacin HC, Edmond MC et al (2015) 214 Traumatic injuries at an emergency department in central Haiti. Ann Emerg Med 66:S79CrossRef Rouhani SA, Eliacin HC, Edmond MC et al (2015) 214 Traumatic injuries at an emergency department in central Haiti. Ann Emerg Med 66:S79CrossRef
20.
go back to reference Marsh RH, Rouhani SA, Pierre P et al (2015) Strengthening emergency care: experience in central Haiti. Lancet Glob Health 3(Suppl 2):S5–S7CrossRefPubMed Marsh RH, Rouhani SA, Pierre P et al (2015) Strengthening emergency care: experience in central Haiti. Lancet Glob Health 3(Suppl 2):S5–S7CrossRefPubMed
21.
go back to reference 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):599–605CrossRefPubMed 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):599–605CrossRefPubMed
22.
go back to reference McCullough C, DeGennaro V Jr, Bagley JK et al (2016) A national trauma capacity assessment of Haiti. J Surg Res 201(1):126–133CrossRefPubMed McCullough C, DeGennaro V Jr, Bagley JK et al (2016) A national trauma capacity assessment of Haiti. J Surg Res 201(1):126–133CrossRefPubMed
31.
go back to reference Anh TT, Anh TT, Dao NX (2005) The cost of road traffic accident in Vietnam. Proc East Asia Soc Transp Stud 5:1923–1933 Anh TT, Anh TT, Dao NX (2005) The cost of road traffic accident in Vietnam. Proc East Asia Soc Transp Stud 5:1923–1933
32.
34.
go back to reference 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 62:45–51CrossRef 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 62:45–51CrossRef
35.
go back to reference 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 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
36.
go back to reference Nguyen H, Ivers R, Jan S et al (2012) Catastrophic household costs due to injury in Vietnam. J Inj 44(5):684–690CrossRef Nguyen H, Ivers R, Jan S et al (2012) Catastrophic household costs due to injury in Vietnam. J Inj 44(5):684–690CrossRef
37.
go back to reference 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 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
38.
go back to reference 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 48:141–142PubMed 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 48:141–142PubMed
40.
go back to reference 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 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
41.
go back to reference 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 24:1814–1824CrossRefPubMed 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 24:1814–1824CrossRefPubMed
42.
go back to reference Plummer JM, Brown H, Jones K et al (2010) Trauma: the burden of a preventable problem. West Indian Med J 59:26–28PubMed Plummer JM, Brown H, Jones K et al (2010) Trauma: the burden of a preventable problem. West Indian Med J 59:26–28PubMed
43.
go back to reference Kaya E, Ozguc H, Tokyay R et al (1999) Financial burden of trauma care on a university hospital in a developing country. J Trauma 47:738–745CrossRef Kaya E, Ozguc H, Tokyay R et al (1999) Financial burden of trauma care on a university hospital in a developing country. J Trauma 47:738–745CrossRef
45.
go back to reference Allard D, Burch VC (2005) The cost of treating serious abdominal firearm-related injuries in South Africa. South Afr Med J 95:591–594 Allard D, Burch VC (2005) The cost of treating serious abdominal firearm-related injuries in South Africa. South Afr Med J 95:591–594
Metadata
Title
The Economic and Social Burden of Traumatic Injuries: Evidence from a Trauma Hospital in Port-au-Prince, Haiti
Authors
Christopher Zuraik
John Sampalis
Alexa Brierre
Publication date
01-06-2018
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 6/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-017-4360-5

Other articles of this Issue 6/2018

World Journal of Surgery 6/2018 Go to the issue