Advertisement

The Financial Burden of Road Traffic Injuries in Mozambique: A Hospital-Related Cost-of-Illness Study of Maputo Central Hospital

  • Ipshita Prakash
  • Otilia Neves
  • Eduardo Cumbe
  • Fadi Hamadani
  • Tarek Razek
  • Paola Fata
  • Andrew Beckett
  • Kosar Khwaja
  • Jeremy Grushka
  • Evan G. Wong
  • Mario Jacobe
  • Assis de Costa
  • Dan L. DeckelbaumEmail author
  • Prem Yohannan
Original Scientific Report
  • 6 Downloads

Abstract

Background

Road traffic injuries (RTIs) are increasingly being recognized for their significant economic impact. Mozambique, like other low-income countries, suffers staggering rates of road traffic collisions. To our knowledge, this is the first study to estimate direct hospital costs of RTIs using a bottom-up, micro-costing approach in the Mozambican context. This study aims to calculate the direct, inpatient costs of RTIs in Mozambique and compare it to the financial capacity of the Mozambican public health care system.

Methods

This was a retrospective, single-centre study. Charts of all patients with RTIs admitted to Maputo Central Hospital over a period of 2 months were reviewed. The costs were recorded and analysed based on direct costs, human resource costs, and overhead costs. Costs were calculated using a micro-costing approach.

Results

In total, 114 patients were admitted and treated for RTIs at Maputo Central Hospital during June–July 2015. On average, the hospital cost per patient was US$ 604.28 (IQR 1033.58). Of this, 44% was related to procedural costs, 23% to diagnostic imaging costs, 17% to length-of-stay costs, 9% to medication costs, and 7% to laboratory test costs. The average annual inpatient cost of RTIs in Mozambique was almost US$ 116 million (0.8% of GDP).

Conclusion

The financial burden of RTIs in Mozambique represents approximately 40% of the annual public health care budget. These results help highlight the economic impact of trauma in Mozambique and the importance of an organized trauma system to reduce such costs.

Notes

Funding

The study was partly supported by funds from the 2015 McGill University Global Health travel award, granted to author I. Prakash. These funds supported the travel and living expenses of the author, which were required for the data collection portion of the study.

Compliance with ethical standards

Conflict of interest

Authors O. Neves and D. Deckelbaum received financial support from Grand Challenges Canada for the implementation of a trauma registry in Mozambique, which was unrelated to this work.

References

  1. 1.
    Smith JN (2015) Epic measures: one doctor, seven billion patients. Harper Wave, New York, pp 7–15Google Scholar
  2. 2.
    Mathers CD, Boerma JT, Fat DM (2009) Global and regional causes of death. Br Med Bull 92(1):7–32CrossRefGoogle Scholar
  3. 3.
    Murray C, Lopez A (2015) Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 385(9963):117–171CrossRefGoogle Scholar
  4. 4.
    Toroyan T, Iaych K, Peden M (2013) Global status report on road safety 2013: supporting a decade of action. World Health Organization, GenevaGoogle Scholar
  5. 5.
    Romao F, Nizamo H, Mapasse D et al (2003) Road traffic injuries in Mozambique. Int J Inj Control Saf Promot 10(1–2):63–67CrossRefGoogle Scholar
  6. 6.
    Parkinson F, Kent SJW, Aldous C et al (2014) The hospital cost of road traffic accidents at a South African regional trauma centre: a micro-costing study. Injury 45(1):342–345CrossRefGoogle Scholar
  7. 7.
    Hamadani F, Neves O, Mocumbi A et al (2014) Introducing a trauma registry in Mozambique: an ethics case study. Int J Clin Med 5:949–955CrossRefGoogle Scholar
  8. 8.
    Mozambique Budget Brief 2017: Health Sector (2017) UNICEF. Retrieved December 5, 2018 from https://www.unicef.org/esaro/UNICEF_Mozambique_–_2017_–_Health_Budget_Brief.pdf
  9. 9.
    Hamadani F, Razek T, Massinga E et al (2019) Trauma surveillance and registry development in Mozambique: results of a 1-year study and the first phase of national implementation. World J Surg 43(7):1628–1635.  https://doi.org/10.1007/s00268-019-04947-7 CrossRefGoogle Scholar
  10. 10.
    Bhalla K, Sharaz S, Abraham J et al (2011) Road injuries in 18 countries: methods, data sources, and estimates of the national incidence of road injuries. Harvard School of Public Health, Boston. Retrieved July 30, 2015 from http://trid.trb.org/view/1251334
  11. 11.
    Global Health Expenditure Database (2014) The World Health Organization. Retrieved August 10, 2015 from http://apps.who.int/nha/database/ViewData/Indicators/en
  12. 12.
    Mozambique (2015) The World Bank. Retrieved July 26, 2015 from http://data.worldbank.org/country/mozambique
  13. 13.
    Mogyorosy Z, Smith P (2005) The main methodological issues in costing health care services: a literature review. Working papers, 007cherp, Centre for Health Economics, University of YorkGoogle Scholar
  14. 14.
    Peden M, Scurfield R, Sleet D et al (2004) World report on road traffic injury prevention. World Health Organization, Geneva, pp 5–6Google Scholar

Copyright information

© Société Internationale de Chirurgie 2019

Authors and Affiliations

  • Ipshita Prakash
    • 1
    • 2
  • Otilia Neves
    • 3
  • Eduardo Cumbe
    • 4
  • Fadi Hamadani
    • 1
    • 2
  • Tarek Razek
    • 1
    • 2
  • Paola Fata
    • 1
  • Andrew Beckett
    • 1
  • Kosar Khwaja
    • 1
  • Jeremy Grushka
    • 1
  • Evan G. Wong
    • 1
    • 2
  • Mario Jacobe
    • 4
  • Assis de Costa
    • 4
  • Dan L. Deckelbaum
    • 1
    • 2
    Email author
  • Prem Yohannan
    • 4
  1. 1.Department of Surgery, Montreal General HospitalMcGill UniversityMontrealCanada
  2. 2.Centre for Global SurgeryMcGill UniversityMontrealCanada
  3. 3.Ministry of HealthMaputoMozambique
  4. 4.Department of SurgeryMaputo Central HospitalMaputoMozambique

Personalised recommendations