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. 2017 Mar 31;30(1):9-12.

Cost-utility of burns management in Nigeria: a case study of the National Orthopaedic Hospital, Enugu

C E Okafor  1 , O Onunka  2 , L N Idoko  3
Affiliations

Cost-utility of burns management in Nigeria: a case study of the National Orthopaedic Hospital, Enugu

C E Okafor et al. Ann Burns Fire Disasters. .

Abstract
in English, French

A major problem of burns is the high cost of management, as well as the discrimination and disability they can cause to patients. Maximising resource utilisation is of key importance for lower-middle-income countries (LMICs) like Nigeria. There is a need to know if Nigerian patients who were victims of burns get the best value for money. This study aimed to evaluate the average cost of managing burns in Nigeria, and determine if the treatment approach is cost-effective. The study was a cost-utility analysis from the perspective of health service providers in Nigeria, a case study of the National Orthopaedic Hospital Enugu (NOHE) using 2013 Microsoft excel. Data on the cost of burn management were obtained from a retrospective study conducted in NOHE in 2012 on 285 patients. Costs were adjusted to reflect the future (2015) value using a real interest rate of 3%. These costs were presented in 2015 US dollars, and a discount rate of 3% was used for both cost and outcome. Health outcome was presented in disability adjusted life years (DALYs). Based on a cost-effectiveness threshold of $2,758.4 (i.e. representing Nigerian GDP/capita), burn management is cost-effective in Nigeria ($526.68/DALY averted). The result also showed that the cost of managing burns in Nigeria is $7,123.28 per patient, which is more than the average income. Burn management in Nigeria is cost-effective but too expensive for most Nigerians to afford.

Un des problèmes de la prise en charge des brûlés est son coût, ainsi que la discrimination et le handicap que la brûlure peut entraîner. L’optimisation des ressources financières est d’une importance cruciale dans les pays en développement comme le Nigeria et il est nécessaire de savoir si les finances engagées se révèlent utiles. Cette étude a pour but d’évaluer le coût de prise en charge des brûlés au Nigeria, et d’évaluer l’efficacité du traitement, à partir des données de l’Hôpital Orthopédique National (HON) d’Enugu. Les données des 285 patients hospitalisés dans l’HON pour brûlures en 2012 ont été analysées. Les chiffres de 2012 ont été extrapolés à 2015 en tenant compte d’une inflation de 3%. L’état de santé après traitement a été chiffré en Espérance de Vie Corrigée de l’Incapacité (EVCI). Le coût de traitement d’une brûlure est de 7 123,28$ soit 526,68$ par année d’ECVI gagnée et la prise en charge des brûlés apparaît donc utile, en termes médico-économiques. Ce coût est cependant à rapporter au PIB per capita du Nigeria, qui est de 2 758,40$. La prise en charge des brûlés au Nigeria, bien que trop chère pour la plupart des nigérians, est efficace financièrement.

Keywords: Nigeria; burns; cost-utility; disability adjusted life years (DALYs); management.

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Figures

Table I
Table I. Mortality rate and frequency of burns
Table II
Table II. Parameter input and distribution
Table III
Table III. Mortality and YLL based on age distribution
Table IV
Table IV. Incremental cost-effectiveness ratio result
See this image and copyright information in PMC

References

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