title: Cost and impoverishment 1 year after hospitalisation due to injuries: a cohort study in Thái Bình, Vietnam.
abstract: BACKGROUND
  Evidence on the economic impact on individuals and their families following an injury in Vietnam is limited. This study examines the costs and the risk of impoverishment due to hospitalised injuries at 12 months following hospital discharge and associated factors.
  
  
  METHODS
  Employing a prospective cohort design, 892 people hospitalised for injury were recruited from Thái Bình General Hospital in Vietnam in 2010 and followed up for 12 months. All out-of-pocket costs incurred and income lost by injured persons and their caregivers associated with care and treatment of their injuries were reported. To examine associated factors, we used generalised estimating equation models for costs and modified Poisson regression for the risk of impoverishment.
  
  
  RESULTS
  The mean total costs by 12 months postdischarge were US$804, nearly 1.2 times the annual average income. Injuries that incurred highest costs were falls (US$950) and road traffic injuries (RTIs) (US$794). At 12-month follow-up, 181 persons (26.9%) became impoverished, with those injured in RTIs and falls at highest risk (26.1% and 35.4%, respectively). Factors associated with higher costs were also those associated with higher risk of impoverishment. These include those injured in RTIs or falls; having higher severity level; principal injured region as upper extremities, lower extremities or head; physical nature of injuries as fracture or concussion injuries; and longer hospitalisation.
  
  
  CONCLUSIONS
  Injuries impose significant economic burden on injured persons and their families during and beyond hospitalisation. In addition to prevention, there is a need to reform health financing system to protect injured persons from significant out-of-pocket expense for healthcare services.
authors.affiliation: School of Population Health, University of South Australia, Adelaide, South Australia, Australia.
authors.forename: Ha
authors.initials: H
authors.lastname: Nguyen
authors.affiliation: The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ivers
authors.affiliation: The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Jan
authors.affiliation: The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Martiniuk
authors.affiliation: School of Population Health, University of South Australia, Adelaide, South Australia, Australia.
authors.forename: Leonie
authors.initials: L
authors.lastname: Segal
authors.affiliation: The Center for Injury Policy and Prevention Research, Hanoi School of Public Health, Hanoi, Vietnam.
authors.forename: Cuong
authors.initials: C
authors.lastname: Pham
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017281:Cost of Illness; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics*; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011203:Poverty / Q000706:statistics & numerical data*; D011446:Prospective Studies; D014744:Vietnam; D014947:Wounds and Injuries / Q000191:economics*; D055815:Young Adult