title: Economic Burden of Hospitalization Due to Injuries in North India: A Cohort Study.
abstract: There is little documentation of the potential catastrophic effects of injuries on families due to out of pocket (OOP) expenditure for medical care. Patients who were admitted for at least one night in a tertiary care hospital of Chandigarh city due to injury were recruited and were followed-up at 1, 2 and 12 months after discharge to collect information on OOP expenditure. Out of the total 227 patients, 60% (137/227) had sustained road traffic injuries (RTI). The average OOP expenditure per hospitalisation and up to 12 months post discharge was USD 388 (95% CI: 332-441) and USD 1046 (95% CI: 871-1221) respectively. Mean OOP expenditure for RTI and non-RTI cases during hospitalisation was USD 400 (95% CI: 344-456) and USD 369 (95% CI: 313-425) respectively. The prevalence of catastrophic expenditure was 30%, and was significantly higher among those belonging to the lowest income quartile (OR-26.50, 95% CI: 6.70-105.07, p-value: <0.01) and with an inpatient stay greater than 7 days (OR-10.60, 95% CI: 4.21-26.64, p-value: <0.01). High OOP expenditure for treatment of injury puts a significant economic burden on families. Measures aimed at increasing public health spending for prevention of injury and providing financial risk protection are urgently required in India.
authors.affiliation: School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India. shankarprinja@gmail.com.
authors.forename: Shankar
authors.initials: S
authors.lastname: Prinja
authors.affiliation: The George Institute for Global Health, University of Sydney 2000, Australia. jjagnoor@georgeinstitute.org.au.
authors.forename: Jagnoor
authors.initials: J
authors.lastname: Jagnoor
authors.affiliation: School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India. akashchauhan23@gmail.com.
authors.forename: Akashdeep Singh
authors.initials: AS
authors.lastname: Chauhan
authors.affiliation: Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India. drsameer35@yahoo.co.in.
authors.forename: Sameer
authors.initials: S
authors.lastname: Aggarwal
authors.affiliation: Health Economics and Social Policy Group, School of Health Sciences, The University of South Australia, South Australia 5000, Australia. Ha.Nguyen2@unisa.edu.au.
authors.forename: Ha
authors.initials: H
authors.lastname: Nguyen
authors.affiliation: The George Institute for Global Health, University of Sydney 2000, Australia. rivers@georgeinstitute.org.au.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ivers
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005382:Financing, Personal; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007194:India / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011203:Poverty; D011446:Prospective Studies; D014947:Wounds and Injuries / Q000191:economics* / Q000453:epidemiology; D055815:Young Adult
keywords: catastrophic expenditure; distress financing; injury; out of pocket expenditure (OOP)