Cost analysis of road traffic crashes in a tertiary hospital in Mpumalanga Province, South Africa

• Published in: Cogent medicine 2018-01, Vol.5 (1), p.1549800
• Main Authors: Matiwane, Busisiwe Precious, Mahomed, Ozayr
• Format: Article
• Language: English
• Subjects: Cost analysis; Fatalities; Head and neck; Injuries; Patients; Risk groups; road traffic crashes; road traffic injuries; Sensitivity analysis; South Africa; tertiary hospital; Traffic accidents & safety
• ISSN: 2331-205X; 2331-205X; 2770-7571
• DOI: 10.1080/2331205X.2018.1549800

Background: Road traffic crashes (RTCs) are an important cause of injury and fatality in low-middle-income countries. In South Africa, they result in 7.8% of gross domestic product losses. The aim of the study was to estimate the cost of inpatient management of RTC injured patients in a tertiary hospital in Mpumalanga Province between 1 April 2015 and 31 March 2016. Methods: A cost analysis of patient care following a road traffic injury (RTI) was conducted using a mixed-costing approach. A retrospective review of hospital records was conducted to extract services consumed by patients during hospital admission between 1 April 2015 and 31 March 2016. Patient and financial records for the period 2015/2016 were used to obtain expenditure information. The bottom-up approach and top-down approach were used to calculate direct costs and indirect costs respectively. A sensitivity analysis was conducted to analyse how changes in resource use change the average costs. An average exchange rate of R13, 50 is equivalent to US$1 was used. Results: The majority of admissions were young males (72%) and those aged 20-34 years (53%). The patients were commonly injured in motor vehicle crashes (62%) sustaining head and neck injuries (32%) and fractures (23%). The total costs were R11,014,187 (US$815,865) with direct and indirect costs amounting to R5,995,872 (US$444,138) and R5,018,315 (US$371,207) respectively. The average cost per patient per day for RTIs was R256,382 (US$18,991). Conclusion: The economically active population and male gender were high risk groups with the main cost drivers being surgical sundries and medication. Direct management of patients accounted for high hospital costs. It is recommended that in addition to implementing a multipronged health promotion intervention to reduce the burden of RTCs, a further cost analysis using a time-motion study of patients admitted with RTIs be conducted to correctly analyse the costs incurred by the hospital.