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

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  • Yira Natalia Alfonso

    (Department of Population Family and Reproductive health, International Injury Research Unit, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA)

  • Olakunle Alonge

    (Department of International Health, International Injury Research Unit, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA)

  • Dewan Md Emdadul Hoque

    (Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka 1212, Bangladesh)

  • Md Kamran Ul Baset

    (Centre for Injury Prevention and Research, Dhaka 1206, Bangladesh)

  • Adnan A. Hyder

    (Department of International Health, International Injury Research Unit, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA)

  • David Bishai

    (Department of Population Family and Reproductive health, International Injury Research Unit, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA)

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.

Suggested Citation

  • Yira Natalia Alfonso & Olakunle Alonge & Dewan Md Emdadul Hoque & Md Kamran Ul Baset & Adnan A. Hyder & David Bishai, 2017. "Care-Seeking Patterns and Direct Economic Burden of Injuries in Bangladesh," IJERPH, MDPI, vol. 14(5), pages 1-9, April.
    • Handle: RePEc:gam:jijerp:v:14:y:2017:i:5:p:472-:d:97147
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    References listed on IDEAS

    as
    1. Siran He & Olakunle Alonge & Priyanka Agrawal & Shumona Sharmin & Irteja Islam & Saidur Rahman Mashreky & Shams El Arifeen, 2017. "Epidemiology of Burns in Rural Bangladesh: An Update," IJERPH, MDPI, vol. 14(4), pages 1-11, April.
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    3. Eddy van Doorslaer & Owen O'Donnell & Ravindra P. Rannan-Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Charu C. Garg & Deni Harbianto & Alejandro N. Herrin & Mohammed Nazmul Huq & Shamsia Ibragimo, 2007. "Catastrophic payments for health care in Asia," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1159-1184.
    4. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
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