Economic loss due to traumatic injury in Uganda: The patient's perspective

Injury. 2016 May;47(5):1098-103. doi: 10.1016/j.injury.2015.11.047. Epub 2015 Dec 11.

Abstract

Introduction: Traumatic injury is a growing public health concern globally, and is a major cause of death and disability worldwide. The purpose of this study was to quantify the socioeconomic impact of lower extremity fractures in Uganda.

Methods: All adult patients presenting acutely to Uganda's national referral hospital with a single long bone lower extremity fracture in October 2013 were recruited. Consenting patients were surveyed at admission and again at six-months and 12-months post-injury. The primary outcome was the cumulative 12-month post-injury loss in income. Secondary outcome measures included the change in health-related quality of life (HRQoL) and the injury's effect on school attendance for the patients' dependents.

Results: Seventy-four patients were recruited during the study period. Sixty-four (86%) of the patients were available for 12-months of follow-up. Compared to pre-injury earnings, patients lost 88.4% ($1822 USD) of their annual income in the 12-months following their injury. To offset this loss in income, patients borrowed an average of 28% of their pre-injury annual income. Using the EuroQol-5D instrument, the mean HRQoL decreased from 0.91 prior to the injury to 0.39 (p<0.0001) at 12-months post-injury. Ninety-three percent of school-aged dependents missed at least one month of school during their guardian's recovery and only 61% had returned to school by 12-months post-injury.

Conclusion: This study demonstrates that lower extremity fractures in Uganda had a profound impact on the socioeconomic status of the individuals in our sample population, as well as the socioeconomic health of the family unit.

Keywords: Africa; Dependent; Economics; Income; Lower extremity fractures; Road traffic injury; Trauma; Uganda.

MeSH terms

  • Adult
  • Disability Evaluation
  • Female
  • Follow-Up Studies
  • Fractures, Bone / economics*
  • Fractures, Bone / epidemiology*
  • Fractures, Bone / psychology
  • Hospitalization / economics*
  • Humans
  • Income / statistics & numerical data*
  • Male
  • Middle Aged
  • Prospective Studies
  • Socioeconomic Factors
  • Uganda / epidemiology