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Review
. 2017 Apr 29;14(5):472.
doi: 10.3390/ijerph14050472.

Care-Seeking Patterns and Direct Economic Burden of Injuries in Bangladesh

Natalia Y Alfonso  1 , Olakunle Alonge  2 , Dewan Md Emdadul Hoque  3 , Kamran Ul Baset  4 , Adnan A Hyder  5 , David Bishai  6
Affiliations
Review

Care-Seeking Patterns and Direct Economic Burden of Injuries in Bangladesh

Natalia Y Alfonso et al. Int J Environ Res Public Health. .

Abstract

This study provides a comprehensive review of the care-seeking patterns and direct economic burden of injuries from the victims' perspective in rural Bangladesh using a 2013 household survey covering 1.17 million people. Descriptive statistics and bivariate analyses were used to derive rates and test the association between variables. An analytic model was used to estimate total injury out-of-pocket (OOP) payments and a multivariate probit regression model assessed the relationship between financial distress and injury type. Results show non-fatal injuries occur to 1 in 5 people in our sample per year. With average household size of 4.5 in Bangladesh--every household has an injury every year. Most non-fatally injured patients sought healthcare from drug sellers. Less than half of fatal injuries sought healthcare and half of those with care were hospitalized. Average OOP payments varied significantly (range: $8-$830) by injury type and outcome (fatal vs. non-fatal). Total injury OOP expenditure was $$355,795 and $5000 for non-fatal and fatal injuries, respectively, per 100,000 people. The majority of household heads with injuries reported financial distress. This study can inform injury prevention advocates on disparities in healthcare usage, OOP costs and financial distress. Reallocation of resources to the most at risk populations can accelerate reduction of preventable injuries and prevent injury related catastrophic payments and impoverishment.

Keywords: Bangladesh; care-seeking patterns; cost; economic burden; injuries; low-and-middle-income countries; out-of-pocket.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Total direct out-of-pocket expenditure from injuries for every 100,000 people from the study area.
Figure 2
Figure 2
Non-fatal injuries direct average cost by cost category and injury type.
See this image and copyright information in PMC

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