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679 Economic impact and care-seeking patterns of injuries in Bangladesh
  1. Y Natalia Alfonso1,
  2. David Bishai1,
  3. Olakunle Alonge2,
  4. Emdadul Hoque3
  1. 1Johns Hopkins University Bloomberg School of Public Health, Department of Family Population and Reproductive Health. Baltimore MD USA
  2. 2Johns Hopkins University Bloomberg School of Public Health, Department of International Health. Baltimore MD USA
  3. 3International Centre for Diarrhoeal Disease Research, Bangladesh

Abstract

This study aims to provide an understanding of the economic hardship of individuals with unintentional injuries and economic recovery options in rural Bangladesh by assessing the variation in mortality and morbidity due to injuries and estimating the economic burden of injuries by type of injury.

Data were obtained from an annual demographic and injury surveillance system conducted in 7 sub-districts in rural Bangladesh during fiscal year 2014–2015. We tabulated injury prevalence and care-seeking patterns by injury type, age group and socioeconomic status (SES) and applied Chi square tests. A two part model of spending applied a generalised linear model to estimate the probability of any spending and amount of out-of-pocket costs per injury type. Lastly, a Markov model was developed to estimate the probability and cost for each type of injury.

There were 1,163,290 individuals and 119,669 self-reported injuries. The most common injuries were from falls (38%), cuts (22%), blunt objects (10%), and transport (9%). Drownings and violence injuries were more common among low SES, while electrocution were more common among high SES. Most injuries (88%) sought treatment, 81% used village doctors, 3% were hospitalised for a median of 5 days, and 25% of the hospitalised had surgery. Of those treated, 4% reported no improvement in health. The mean and median cost for treated injuries, in 2015 BDT, was $1,302 and $250, respectively. Most treatments incurred expenditures on medicines (95% median $250), 31% on transport cost (median $100) and 15% on consultation fees (median $220). The most expensive injury treatments were other ($6,125), attempted suicide ($2,000), violence ($680), and unintentional poisoning ($600). Other results will be shown later.

Data highlights injuries common among lowest or highest SES, treatment outcome patterns, and most common and most expensive health care services and injury types. This new evidence can improve understanding on health care use, the economic hardship and recovery options of individuals with injuries in rural Bangladesh.

  • Unintentional Injuries
  • Cost
  • Economic burden
  • Bangladesh
  • Developing Country

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