A cost analysis of conservative management of spinal cord-injured patients in Nigeria

Abstract

Study design: A prospective study. Objectives: To determine the cost of acute phase of injury (ASCI) among spinal cord-injured patients managed conservatively in Nigeria. Settings: Gwagwalada, Abuja. Methods: Over a 1-year period (1 January 2009 to 31 December 2009), the cost of ASCI of consecutive spinal cord-injured patients, gainfully employed preinjury, who paid the hospital bill directly from their purses and could estimate their daily income, and who were managed conservatively for 6 weeks before discharge to rehabilitation, was prospectively examined. Results: A total of 34 cases of spinal cord-injured patients with a mean age of 35.4±12.8 years were included in this study. The mean cost of ASCI over 6 weeks was $1598.29, an average of 6.4-232.8% of patients' annual income where 450% of the people live on less than a dollar a day. The mean cost of hospitalization was 14.9% of the total cost of ASCI in this study. It was significantly more expensive to treat tetraplegics compared with paraplegics. Conclusion: This study identified the cost of acute phase of spinal cord injury in Nigeria to assist clinicians in planning treatment that could reduce financial burden on the patients but optimize patients' care.

Loss of work-related income impoverishes people with SCI and their families in Bangladesh

“…The situation may be quite different in other LMICs or other parts of Bangladesh. For example, one study from Nigeria found that 41% of participants used 50% of their annual income to meet the acute medical costs of an injured person [17]. This does not include the ongoing costs incurred after discharge from hospital.…”

“…In addition, attention needs to continue to be directed at getting those injured back to work. For this purpose, vocational training needs to be at the centre of any rehabilitation program [13,17]. A study from Nepal found that less than half of those with an SCI had any income many years after discharge from hospital [38].…”

“…SCI causes hardship for those who are injured and often also for the families who are financially dependent on them [3,[13][14][15]. The loss of income and additional medical and ongoing costs associated with the injury place a large financial strain on families [16,17]. Not surprisingly, therefore, SCI in Bangladesh and other LMIC often throws families into extreme poverty [18][19][20].…”

Spinal cord and spine trauma in a large teaching hospital in Ghana

“…Spinal cord injury (SCI) is a devastating injury, with its effect going beyond the injured patient to the care givers and family and with economic implications that can be long lasting. [1][2][3][4][5][6][7] The disability that it brings has been known to have long lasting effects with very little available to restore its functions 7 . Beyond the temporary or permanent loss of motor, sensory and autonomic functions, the patient may suffer psychologically, and the injury may demand difficult psychological and social adjustments from family members as well.…”

Non-operative management is superior to surgical stabilization in spine injury patients with complete neurological deficits: Some additional perspectives

“…Similar findings have been recently been reported from Nigeria where non-surgical management is more cost-effective than surgical interventions. [4]…”