Economic Burden of Road Traffic Injuries in Nepal

The evidence of the economic burden of road traffic injuries (RTIs) in Nepal is limited. The most recent study, conducted in 2008, is now considered outdated because there has been a rapid increase in vehicle numbers and extensive road building over the last decade. This study estimated the current economic costs of RTIs in Nepal, including the direct costs, productivity costs, and valuation of pain, grief, and suffering. An incidence-based cost-of-illness analysis was conducted from a societal perspective, employing a bottom-up approach using secondary data. All costs incurred by the patients, their family members, and costs to society were estimated, with sensitivity analyses to consider uncertainty around the data estimates available. Productivity loss was valued using the human capital approach. The total costs of RTIs in 2017 were estimated at USD 122.88 million. Of these, the costs of productivity loss were USD 91.57 million (74.52%) and the pain, grief, and suffering costs were USD 18.31 million (14.90%). The direct non-medical costs were USD 11.50 million (9.36%) whereas the direct medical costs were USD 1.50 million (1.22%). The economic costs of RTIs increased by threefold since 2007 and are equivalent to 1.52% of the gross national product, indicating the growing national financial burden associated with preventable RTIs.

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Medical Costs and Economic Burden Caused by Road Traffic Injuries in Iran

Trauma Monthly ◽

10.5812/traumamon.35997 ◽

2016 ◽

Vol 22 (2) ◽

Cited By ~ 3

Author(s):

Hamid Reza Behnood ◽

Mashyaneh Haddadi ◽

Shadrokh Sirous ◽

Elaheh Ainy ◽

Reza Rezaei

Keyword(s):

Economic Burden ◽

Road Traffic ◽

Medical Costs ◽

Road Traffic Injuries

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Removing the Economic Burden of Road Traffic Injuries from Patients: A Successful Model

Journal of Injury and Violence Research ◽

10.5249/jivr.v7i2.744 ◽

2015 ◽

Keyword(s):

Economic Burden ◽

Road Traffic ◽

Road Traffic Injuries ◽

Successful Model

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Economic and social burden due to injuries and violence in Nepal: A cross-sectional study

Kathmandu University Medical Journal ◽

10.3126/kumj.v7i4.2752 ◽

1970 ◽

Vol 7 (4) ◽

pp. 344-350 ◽

Cited By ~ 6

Author(s):

SK Joshi ◽

S Shrestha

Keyword(s):

Economic Burden ◽

Road Traffic ◽

Cross Sectional Study ◽

Cross Sectional ◽

Road Traffic Injuries ◽

Social Burden ◽

Two Cities ◽

Inability To Work ◽

Causes Of Deaths ◽

Injured Patients

Background: Injury and violence cause five million deaths annually in the world which is around 9% of the global mortality. Eight out of fifteen leading causes of deaths in the age group 15-25 years are injury related. Objective: The objective of this study was to assess the incidence, severity and socio-economic burden of injuries and violence in two cities of Nepal. Materials and methods: Relevant data was collected from 17th August 2008 to 16th September 2008 from injured patients attending emergency departments at six health centres in two cities. Results: In total, 505 injury cases were reported. 42.5% of the injuries occurred in roads and 34.1% at home. 65% of road traffic injuries involved motorcycles. The majority (60%) of the injured subjects were economically active. A single injury case cost 126.2 US$ including all the expenses and the loss due to inability to work. Conclusion: The high incidence of injuries, especially road traffic injuries, adds a huge economic burden to nation. Key words: disabilities; economic burden; injuries; violence DOI: 10.3126/kumj.v7i4.2752 Kathmandu University Medical Journal (2009) Vol.7, No.4 Issue 28, 344-350

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Out of pocket costs and financial toxicity experienced by patients in early phase clinical trials.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e18383 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e18383-e18383

Author(s):

Ryan Huey ◽

Goldy George ◽

Penny Phillips ◽

Revenda White ◽

Siqing Fu ◽

...

Keyword(s):

Clinical Trials ◽

Cancer Patients ◽

Economic Burden ◽

Therapeutic Option ◽

Financial Burden ◽

Medical Costs ◽

Financial Toxicity ◽

Phase I Clinical Trials ◽

Medical Expenses ◽

Early Phase Clinical Trials

e18383 Background: Clinical trials are an important therapeutic option for cancer patients. Although financial burden in cancer treatment is well-described, the financial burden associated with clinical trials is not well understood, especially for patients with lower socioeconomic status. Methods: We conducted a survey regarding economic burden and financial toxicity among cancer patients on Phase I clinical trials for at least 1 month. Financial Toxicity Score (FTS) was assessed using the validated COmprehensive Score for Financial Toxicity (COST) survey (scale 0-44, lower scores indicating worse financial toxicity). Patients also reported monthly out of pocket (OOP) medical and non-medical expenses. Results: Of 147 consecutive patients approached, 105 agreed to participate; median age = 60y; 62% female; 49% had annual income < $60K; 50% lived < 300 miles from the clinic; 34% required air travel; 41% had Medicare, 50% had employer sponsored insurance. Median FTS = 20, with interquartile range of 12.5. Median monthly OOP costs for non-medical expenses was $985, and for medical expenses was $475. Median total monthly OOP costs was $1695. Compared to patients in the highest quartile of FTS, a significantly lower % of patients in the lowest (worst) quartile of FTS had incomes > $60K (27% v. 77%, P < 0.001), and a significantly higher % were unemployed or not working outside the home (54% v. 12%, P = 0.001), and incurred higher than expected medical (39% vs. 12%, P = 0.025) and non-medical (64% vs. 15%, P = 0.003) expenses. Compared with patients for whom medical costs were not much higher than expected, a significantly higher % of patients with medical costs much higher than expected were non-White (77% v. 46%, P = 0.004) and unemployed/not working outside the home (46% v. 19%, P = 0.009). Conclusions: Among cancer patients participating on clinical trials, economic burden is high and financial toxicity is disproportionally higher in patients with lower income. OOP costs can be substantial and are often unexpected for patients.

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The economic burden of cervical cancer in Eswatini: Societal perspective

PLoS ONE ◽

10.1371/journal.pone.0250113 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0250113

Author(s):

Cebisile Ngcamphalala ◽

Ellinor Östensson ◽

Themba G. Ginindza

Keyword(s):

Cervical Cancer ◽

Economic Burden ◽

Invasive Cervical Cancer ◽

Productivity Loss ◽

Indirect Costs ◽

Premature Mortality ◽

Medical Costs ◽

Cost Driver ◽

Sub Saharan Africa ◽

Care Utilization

Background Cervical cancer imposes considerable economic burden on societies and individuals. There is lack of evidence regarding this from the developing world and particularly from sub-Saharan Africa. Therefore, the study aimed to estimate the societal costs of cervical cancer in Eswatini. Materials and methods The cost of illness study (CoI) was applied using national specific clinical and registry data from hospitals, registries and reports to determine the prevalence of cervical intraepithelial neoplasia (CIN) and cervical cancer in Eswatini in 2018. Cost data included direct medical costs (health care utilization in inpatient and outpatient care), direct non-medical costs (patient costs for traveling) and indirect costs based on productivity loss due to morbidity (patient time during diagnosis and treatment) and premature mortality. Results The estimated total annual cost for cervical cancer was $19 million (ranging between $14 million and $24 million estimated with lower and upper bounds). Direct cost represented the majority of the costs at 72% ($13.7 million) out of which total pre-cancerous treatment costs accounted for 0.7% ($94,161). The management of invasive cervical cancer was the main cost driver with costs attributable to treatment for FIGO III and FIGO IV representing $1.7 million and $8.7 million respectively. Indirect costs contributed 27% ($5.3 million) out of which productivity loss due to premature mortality represented the majority at 67% ($3.5 million). Conclusion The economic burden of cervical cancer in Eswatini is substantial. National public health prevention strategies with prophylactic HPV vaccine and screening for cervical lesions should therefore be prioritized to limit the extensive costs associated with cervical cancer.

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Rethinking the economic costs of hospitalization for malaria: accounting for the comorbidities of malaria patients in western Kenya

Malaria Journal ◽

10.1186/s12936-021-03958-x ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Caroline Watts ◽

Harrysone Atieli ◽

Jason Alacapa ◽

Ming-Chieh Lee ◽

Guofa Zhou ◽

...

Keyword(s):

Health System ◽

Economic Burden ◽

Indirect Costs ◽

Malaria Diagnosis ◽

Medical Costs ◽

Malaria Episode ◽

Economic Costs ◽

Western Kenya ◽

The Mean ◽

Household Costs

Abstract Background Malaria causes significant mortality and morbidity in sub-Saharan Africa, especially among children under five years of age and places a huge economic burden on individuals and health systems. While this burden has been assessed previously, few studies have explored how malaria comorbidities affect inpatient costs. This study in a malaria endemic area in Western Kenya, assessed the total treatment costs per malaria episode including comorbidities in children and adults. Methods Total economic costs of malaria hospitalizations were calculated from a health system and societal perspective. Patient-level data were collected from patients admitted with a malaria diagnosis to a county-level hospital between June 2016 and May 2017. All treatment documented in medical records were included as health system costs. Patient and household costs included direct medical and non-medical expenses, and indirect costs due to productivity losses. Results Of the 746 patients admitted with a malaria diagnosis, 64% were female and 36% were male. The mean age was 14 years (median 7 years). The mean length of stay was three days. The mean health system cost per patient was Kenyan Shilling (KSh) 4288 (USD 42.0) (95% confidence interval (CI) 95% CI KSh 4046–4531). The total household cost per patient was KSh 1676 (USD 16.4) (95% CI KSh 1488–1864) and consisted of: KSh 161 (USD1.6) medical costs; KSh 728 (USD 7.1) non-medical costs; and KSh 787 (USD 7.7) indirect costs. The total societal cost (health system and household costs) per patient was KSh 5964 (USD 58.4) (95% CI KSh 5534–6394). Almost a quarter of patients (24%) had a reported comorbidity. The most common malaria comorbidities were chest infections, diarrhoea, and anaemia. The inclusion of comorbidities compared to patients with-out comorbidities led to a 46% increase in societal costs (health system costs increased by 43% and patient and household costs increased by 54%). Conclusions The economic burden of malaria is increased by comorbidities which are associated with longer hospital stays and higher medical costs to patients and the health system. Understanding the full economic burden of malaria is critical if future malaria control interventions are to protect access to care, especially by the poor.

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Validity and Reliability of The Persian Version of Health-Labour Questionnaire in Determination of Productivity Loss Among Injured of Traffic Accidents

Quarterly Journal of Management Strategies in Health System ◽

10.18502/mshsj.v5i2.4250 ◽

2020 ◽

Author(s):

Hossein Ebrahimipour ◽

Aliasghar Kiadaliri ◽

Hamid Heidarian Miri ◽

Mehdi Yousefi ◽

Mehdi Ariafar ◽

...

Keyword(s):

Content Validity ◽

Traffic Accidents ◽

Road Traffic ◽

Productivity Loss ◽

Kappa Coefficient ◽

Validity And Reliability ◽

Cross Sectional ◽

Road Traffic Injuries ◽

Persian Version ◽

Productivity Losses

Background: Health- Labour Questionnaire (SF-HLQ) is a measurement instrument for collecting the quantitative data on the relationship between disease and functional status of individuals of productivity losses related to health problems in individuals with paid or unpaid work. Since road traffic injuries are the leading cause of death for disability in the world. In this regard, we aimed to report on validity and reliability of the Persian version of Health- Labour questionnaire in assessing Productivity losses of the Road Traffic Injuries. Methods: In this cross-sectional study, a sample of 30 injured of traffic accident referring to hospitals affiliated with Mashhad University of Medical Sciences were randomly selected. Samples were evaluated in 2 stages and have been interviewed following 1 month by using the health- labour questionnaire and their loss of productivity was calculated by telephone. Face and content validity was performed by 5 health management and economics specialists and 10 students of Master's Degree of Health Services Management and their opinions were applied. To determine the content validity of the questionnaire, content validity ratio (CVR) and content validity index (CVI) were used, and to determine reliability, Coefficient Correlation Interclass (ICC) for quantitative variables and kappa coefficient of agreement were used to evaluate the reliability of the nominal questions and SPSS 21 software used for data analysis. Results: CVI and CVR were calculated at 0.79- 0.49, Respectively, which is acceptable for this questionnaire. Intra-class Correlation Coefficient and Confidence interval in both lost productivity and lost working day variables were 0.99 (0.98-0.99) and 0.96 (0.93-0.98) respectively. Kappa coefficient of agreement for nominal questions was 0.99. Conclusion: The results of this study showed that the translated version of the health-labour questionnaire had presented excellent validity and reliability in assessing productivity loss in traffic incident patients.

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Economic Burden of Non-Alcoholic Steatohepatitis with Significant Fibrosis in Thailand

10.21203/rs.3.rs-129625/v1 ◽

2020 ◽

Author(s):

Pochamana Phisalprapa ◽

Ratthanon Prasitwarachot ◽

Chayanis Kositamongkol ◽

Pranaidej Hengswat ◽

Weerachai Srivanichak ◽

...

Keyword(s):

Economic Burden ◽

Financial Burden ◽

Lifetime Cost ◽

Sensitivity Analyses ◽

Thai Population ◽

Lifetime Horizon ◽

Middle Income ◽

Significant Fibrosis ◽

Alcoholic Steatohepatitis ◽

Number Of Patients

Abstract Background: Non-alcoholic steatohepatitis (NASH) has been recognised as a significant form of chronic liver disease and a common cause of cirrhosis and hepatocellular carcinoma, resulting in a considerable financial burden on healthcare resources. Currently, there is no information regarding the economic burden of NASH in low- and middle-income countries (LMICs). The aim of this study was to estimate the economic burden of NASH in Thailand as a lesson learned for LMICs.Methods: To estimate the healthcare costs and prevalence of NASH with significant fibrosis (fibrosis stage ≥ 2) in the general Thai population, an eleven-state lifetime horizon Markov model with 1-year cycle length was performed. The model comprised Thai population aged 18 years and older. The cohort size was based on Thailand Official Statistic Registration Systems. The incidence of NASH, transitional probabilities, and costs-of-illness were based on previously published literature, including systematic reviews and meta-analyses. The age-specific prevalence of NASH was based on Thai NASH registry data. Costs were expressed in 2019 US Dollars ($). As we undertook analysis from the payer perspective, only direct medical costs were included. All future costs were discounted at an annual rate of 3%. A series of sensitivity analyses were performed.Results: The estimated total number of patients with significant NASH was 2.9 million cases in 2019, based on a NASH prevalence of 5.74%. The total lifetime cost of significant NASH was $15.2 billion ($5,147 per case), representing approximately 3% of the 2019 GDP of Thailand. The probabilistic sensitivity analysis showed that the lifetime costs of significant NASH varied from $11.4 billion to $18.2 billion.Conclusions: The economic burden associated with NASH is substantial in Thailand. This prompts clinicians and policy makers to consider strategies for NASH prevention and management.

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Out-of-pocket costs and financial toxicity experienced by patients in early-phase clinical trials.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.27_suppl.8 ◽

2019 ◽

Vol 37 (27_suppl) ◽

pp. 8-8

Author(s):

Ryan Huey ◽

Goldy George ◽

Penny Phillips ◽

Revenda White ◽

Siqing Fu ◽

...

Keyword(s):

Clinical Trials ◽

Cancer Patients ◽

Economic Burden ◽

Therapeutic Option ◽

Financial Burden ◽

Medical Costs ◽

Financial Toxicity ◽

Phase I Clinical Trials ◽

Medical Expenses ◽

Early Phase Clinical Trials

8 Background: Clinical trials are an important therapeutic option for cancer patients. Although financial burden in cancer treatment is well-described, the financial burden associated with clinical trials is not well understood, especially for patients with lower socioeconomic status. Methods: We conducted a survey regarding economic burden and financial toxicity among cancer patients on Phase I clinical trials for at least 1 month. Financial Toxicity Score (FTS) was assessed using the validated COmprehensive Score for Financial Toxicity (COST) survey (scale 0-44, lower scores indicating worse financial toxicity). Patients also reported monthly out of pocket (OOP) medical and non-medical expenses. Results: Of 147 consecutive patients approached, 105 agreed to participate; median age = 60y; 62% female; 49% had annual income < $60K; 50% lived < 300 miles from the clinic; 34% required air travel; 41% had Medicare, 50% had employer sponsored insurance. Median FTS = 20, with interquartile range of 12.5. Median monthly OOP costs for non-medical expenses was $985, and for medical expenses was $475. Median total monthly OOP costs was $1695. Compared to patients in the highest quartile of FTS, a significantly lower % of patients in the lowest (worst) quartile of FTS had incomes > $60K (27% v. 77%, P < 0.001), and a significantly higher % were unemployed or not working outside the home (54% v. 12%, P = 0.001), and incurred higher than expected medical (39% vs. 12%, P = 0.025) and non-medical (64% vs. 15%, P = 0.003) expenses. Compared with patients for whom medical costs were not much higher than expected, a significantly higher % of patients with medical costs much higher than expected were non-White (77% v. 46%, P = 0.004) and unemployed/not working outside the home (46% v. 19%, P = 0.009). Conclusions: Among cancer patients participating on clinical trials, economic burden is high and financial toxicity is disproportionally higher in patients with lower income. OOP costs can be substantial and are often unexpected for patients.

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