Review

. 2014 Sep;29(6):795-808.

doi: 10.1093/heapol/czt064. Epub 2013 Oct 4.

The cost of injury and trauma care in low- and middle-income countries: a review of economic evidence

Hadley K H Wesson¹, Nonkululeko Boikhutso², Abdulgafoor M Bachani², Karen J Hofman², Adnan A Hyder³

Affiliations

¹ International Injury Research Unit, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA, Department of Surgery, Virginia Commonwealth University Medical Center, 1200 East Broad Street, Richmond, VA 23298, USA, University of Witwatersrand Faculty of Health Sciences, School of Public Health, 27 St Andrews Road, Parktown, Johannesburg 2193, Medical Reserach Council, Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of Witwatersrand, 7 York Road, Parktown 2193, Johannesburg, South Africa International Injury Research Unit, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA, Department of Surgery, Virginia Commonwealth University Medical Center, 1200 East Broad Street, Richmond, VA 23298, USA, University of Witwatersrand Faculty of Health Sciences, School of Public Health, 27 St Andrews Road, Parktown, Johannesburg 2193, Medical Reserach Council, Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of Witwatersrand, 7 York Road, Parktown 2193, Johannesburg, South Africa.
² International Injury Research Unit, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA, Department of Surgery, Virginia Commonwealth University Medical Center, 1200 East Broad Street, Richmond, VA 23298, USA, University of Witwatersrand Faculty of Health Sciences, School of Public Health, 27 St Andrews Road, Parktown, Johannesburg 2193, Medical Reserach Council, Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of Witwatersrand, 7 York Road, Parktown 2193, Johannesburg, South Africa.
³ International Injury Research Unit, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA, Department of Surgery, Virginia Commonwealth University Medical Center, 1200 East Broad Street, Richmond, VA 23298, USA, University of Witwatersrand Faculty of Health Sciences, School of Public Health, 27 St Andrews Road, Parktown, Johannesburg 2193, Medical Reserach Council, Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of Witwatersrand, 7 York Road, Parktown 2193, Johannesburg, South Africa ahyder@jhsph.edu.

PMID: 24097794
PMCID: PMC4153302
DOI: 10.1093/heapol/czt064

Review

The cost of injury and trauma care in low- and middle-income countries: a review of economic evidence

Hadley K H Wesson et al. Health Policy Plan. 2014 Sep.

. 2014 Sep;29(6):795-808.

doi: 10.1093/heapol/czt064. Epub 2013 Oct 4.

Authors

Hadley K H Wesson¹, Nonkululeko Boikhutso², Abdulgafoor M Bachani², Karen J Hofman², Adnan A Hyder³

Affiliations

¹ International Injury Research Unit, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA, Department of Surgery, Virginia Commonwealth University Medical Center, 1200 East Broad Street, Richmond, VA 23298, USA, University of Witwatersrand Faculty of Health Sciences, School of Public Health, 27 St Andrews Road, Parktown, Johannesburg 2193, Medical Reserach Council, Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of Witwatersrand, 7 York Road, Parktown 2193, Johannesburg, South Africa International Injury Research Unit, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA, Department of Surgery, Virginia Commonwealth University Medical Center, 1200 East Broad Street, Richmond, VA 23298, USA, University of Witwatersrand Faculty of Health Sciences, School of Public Health, 27 St Andrews Road, Parktown, Johannesburg 2193, Medical Reserach Council, Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of Witwatersrand, 7 York Road, Parktown 2193, Johannesburg, South Africa.
² International Injury Research Unit, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA, Department of Surgery, Virginia Commonwealth University Medical Center, 1200 East Broad Street, Richmond, VA 23298, USA, University of Witwatersrand Faculty of Health Sciences, School of Public Health, 27 St Andrews Road, Parktown, Johannesburg 2193, Medical Reserach Council, Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of Witwatersrand, 7 York Road, Parktown 2193, Johannesburg, South Africa.
³ International Injury Research Unit, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA, Department of Surgery, Virginia Commonwealth University Medical Center, 1200 East Broad Street, Richmond, VA 23298, USA, University of Witwatersrand Faculty of Health Sciences, School of Public Health, 27 St Andrews Road, Parktown, Johannesburg 2193, Medical Reserach Council, Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of Witwatersrand, 7 York Road, Parktown 2193, Johannesburg, South Africa ahyder@jhsph.edu.

PMID: 24097794
PMCID: PMC4153302
DOI: 10.1093/heapol/czt064

Abstract

Introduction: Injuries are a significant cause of mortality and morbidity, of which more than 90% occur in low- and middle-income countries (LMICs). Given the extent of this burden being confronted by LMICs, there is need to place injury prevention at the forefront of public health initiatives and to understand the costs associated with injury. The aim of this article is to describe the extent to which injury-related costing studies have been conducted in LMICs.

Methods: A review of literature was performed to explore costing data available for injury and/or trauma care in LMICs. Study quality was described using recommendations from the Community Guide's quality assessment tool for economic evaluations.

Results: The review identified 68 studies, of which 13 were full economic evaluations. Cost of injury varied widely with mean costs ranging from US$14 to US$17 400. In terms of injury-prevention interventions, cost per disability adjusted life year averted for injury-prevention interventions ranged from US$10.90 for speed bump installation to US$17 000 for drunk driving and breath testing campaigns in Africa. The studies varied in quality, ranging from very good to unsatisfactory.

Discussion: There is a lack of injury-related economic evidence from LMICs. Current costing research has considerable variability in the costs and cost descriptions of injury and associated prevention interventions. The generalizability of these studies is limited. Yet the economic burden of injury is high, suggesting significant potential for cost savings through injury prevention. A standardized approach to economic evaluation of injury in LMICs is needed to further prioritize investing in injury prevention.

Keywords: Injury; costs; developing countries; economic evaluation; trauma.

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Figures

**Figure 1**
Literature review flowchart

**Figure 2**
Comparison between the number of papers published on costs of injury in LMICs (%) and injury-related deaths in LMICs by region and type of injury¹ Source: WHO, Global Burden of Disease 2004 Update. ¹As a percentage of total injuries *Region defined using WHO classification

See this image and copyright information in PMC

References

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The cost of injury and trauma care in low- and middle-income countries: a review of economic evidence

Affiliations

The cost of injury and trauma care in low- and middle-income countries: a review of economic evidence

Authors

Affiliations

Abstract

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical